UNUSUAL PRESENTATION OF REACTIVE ARTHRITIS AFTER SALMONELLA ENTERITIS IN A 6-YEAR-OLD BOY

ABSTRACT: Reactive arthritis, formerly called Reiter’s syndrome is extra-articular oligoarthropathy, which can be due to bacterial infection or genetic predisposition. The infections are either urogenital (chlamydia being most notorious) or gastrointestinal (e.g. salmonella, yersinia, etc.). The human leukocyte antigen (HLA-B27) antigen has been implicated as the most common predisposing factor. Reactive arthritis often involves the joints of the lower limb. Bacterial enteric infections are a potential threat in a Pediatric population that can be due to an acute illness or its sequelae. Reactive arthritis following outbreaks of enteric infections with Salmonella is uncommon in the pediatric population. We report a rare case of a 6 years old boy who came to ER with high-grade fever and severe pain in the right iliac fossa. Clinical diagnosis of appendicitis was made by the physicians on physical exam but after radio-pathological investigation like CBC, ESR, CRP, Blood culture, USG abdomen, CT abdomen, and MRI, diagnosis of reactive arthritis secondary to salmonella enteritis was made and the patient underwent right hip arthrotomy after which he was discharged. Thus, imaging played a pivotal role in the right diagnosis of a patient with proper management guidelines. This also showed that salmonella enteritis can present atypically mimicking septic arthritis or acute appendicitis. Reactive arthritis after salmonella infection is a very rare and one of its kind case reported in Pakistan.

Bacteriocin-mediated inhibition of some common pathogens by wild and mutant Lactobacillus species and in vitro amplification of bacteriocin encoding genes

Lactobacilli are the most common probiotics used in food and other industries because of their capability of producing bacteriocins. Bacteriocins are compounds that are used to kill pathogenic microorganisms. As most bacteria have become resistant to synthetic antibacterial tools, the importance of using probiotics as antibacterial agents has increased. This work was done to check the bacteriocin effect on some common pathogens and the influence of mutation on the bacteriocin activity of Lactobacilli was also investigated. Four strains were isolated, identified from meat and pickles samples via culturing methods, staining, biochemical tests, and ribotyping. Preliminary tests, including Gram staining and catalase test, were done for the confirmation of Lactobacillus species. All strains were gram-positive and catalase-negative. Antibacterial activity was checked against Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus thuringiensis, Escherichia coli, and Salmonella enteritis via agar well diffusion method. The mutations were done using ethidium bromide and the influence of wild and mutants were also checked. Interestingly, mutants developed more virulence than wild ones. It was also observed that they all were sensitive to pepsin. Protein estimation was done via Bradford method. Ribotyping of GCU-W-PS1 revealed 99 % homology with Lactobacillus plantarum and GCU-W-MS1 to Lactobacillus curvatus (99 % homology). Curvacin A, sakacin P, and plantaricin A genes were also amplified using specific primers. Gene sequence showed the presence of curvacin A gene in GCU-W-MS1. It was concluded that lactic acid bacteria could be used as antibacterial tools against common pathogens.

Large Splenic Abscess Caused by Non-Typhoidal Salmonella in a Healthy Child Treated with Percutaneous Drainage

Splenic abscess occurs very rarely in healthy children. Although typhoid fever was the leading cause of splenic abscess in the pre-antibiotic era, Salmonella spp. remain to be the major pathogens causing splenic abscess, with an increasing worldwide frequency of splenic abscess due to non-typhoidal Salmonella infection. Here, we report the case of a 12-year-old boy, who was presumably diagnosed with acute gastroenteritis on admission and eventually diagnosed with a large splenic abscess (maximum diameter, 14.5 cm) caused by non-typhoidal Salmonella. Although splenectomy has been considered in cases of large splenic abscesses, the patient was treated with antibiotics and ultrasonography-guided percutaneous drainage. A detailed physical examination and appropriate imaging studies are necessary for the early diagnosis of extra-intestinal complications of non-typhoidal Salmonella enteritis. For treatment, percutaneous drainage, rather than splenectomy, can be used in large splenic abscesses.

Abdominal abscess associated with salmonellosis − case report

Introduction: Although gastroenteritis is considered to be a non-surgical disease, rare complications necessitating surgical intervention may occur. Case report: We present a patient who underwent acute small bowel resection due to an abdominal abscess, which developed in association with Salmonella enteritis.