Salmonella sepsis in ulcerative colitis: Report of a case and review of the literature

Abstract

Coincident salmonellosis and ulcerative colitis is an uncommon and poorly understood clinical problem. The occurrence of salmonella sepsis in patients with previously diagnosed ulcerative colitis has only been reported twice in the medical literature, and only 1 case was discussed in detail. This article describes the third patient to have concurrent salmonella sepsis and ulcerative colitis - the first without gastrointestinal infection. A detailed report of the patient's long hospital course with fatal outcome is presented, analysis of the possible mechanisms of infection in the patient is discussed in depth, and the medical literature regarding the combination of ulcerative colitis and salmonella infection is reviewed. This case emphasizes the need to culture stools in any patient who presents with a presumed flare up of inflammatory bowel disease to rule out an infectious cause. Also, patients with salmonella colitis should be followed to be certain that they do not have inflammatory bowel disease as well. Antibiotic coverage is recommended for patients with known ulcerative colitis and salmonella infection, although treatment data are lacking.