Pseudo-surgical syndromes produced by salmonella organisms

Comment and summary

In both our cases, it appears from the course of the disease that the occurrence ofSalmonella is not coincidental but is actually the etiological factor. This is confirmed by the presence of fully specific agglutinins and by the increase and decrease of the agglutinin titers corresponding to the clinical course of the infections.

The etiological agent found in the first case(S. typhi murium) is of the ordinary type of Salmonella frequently found in cases of so-called food poisoning. The type of Salmonella isolated in the second case, on the other hand, is herewith reported for the first time in the Western hemisphere. Neither human nor animal infections have been mentioned heretofore as far as we know. The source of the infection has not been found in our case. It may be significant, however, that the patient’s husband is a butcher. In spite of the fact that this type has not yet been found in animals in this country, an animal origin of the infection is likely in the light of the observations reported from Europe, and it is to be expected that further studies will reveal the occurrence of S. morbificans bovis also in animals in this country.

It is advisable for the clinician and especially for the surgeon to pay attention toSalmonella infections not only in cases of gastro-enteritis and of a typhoidlike type, but also in such patients as described above. The patient upon whom we operated suffered no ill consequences. In other cases, however, the operation may endanger the patient in the same way as an unnecessary laparotomy performed during the course of typhoid fever. It is worth while referring to similar observations made during a recent outbreak of paratyphoid fever in Massachusetts. R. F. Feemster and G. W. Anderson (7) mention four patients who were operated upon for appendicitis before the outbreaks were discovered.