Two siblings with allergic purpura following Salmonella O9 enterocolitis

Abstract

Two siblings with allergic purpura after Salmonella O9 infection were reported. A girl (patient 1) aged 4 years and 4 months started to have knee joint pain and abdominal pain followed by purpura of the lower extremities and was referred to us for treatment of allergic purpura. She had contracted enterocolitis one month before visiting our hospital and Salmonella enteritidis was identified. During the course of the illness she had nephritis associated with allergic purpura. However, she made a favorable progress and proteinuria and hematuria disappeared within 6 months. A boy (an elder brother of patient 1) aged 6 years was admitted to our hospital because of the allergic purpura. He similarly had contracted Salmonella enterocolitis. He had severe gastro-intestinal symptoms including abdominal pain, vomiting and bloody stool, which rapidly subsided after initiation of treatment with intravenous hyperalimentation combined with prednisolone. It is possible that allergic purpura in our patients was closely associated with Salmonella enteritidis infection. Further accumulation of cases is a requisite to clarify an association of Salmonella enteritidis infection with allergic purpura and pathogenesis of allergic purpura.