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Recurrent Salmonella sepsis in a patient with Wegener’s granulomatosis

Mariusz Kusztal, Jakub Kuźniar, Barbara Rychlewska, Wacław Weyde, Marian Klinger

CaseRepClinPractRev 2005; 6:124-127

ID: 428834

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Background: Wegener’s granulomatosis (WG) is a granulomatous vasculitis that in typical course involves both the upper respiratory tract and the lung, along with a non-granulomatous necrotizing glomerulonephritis. Immune dysfunction in patients with Wegener’s granulomatosis and immunosuppressive regimen may predispose to recurrent infections.Case Report: We report on a 61-year-old man with WG and renal failure, who experienced 4 times recurrent Salmonella sepsis with positive blood, urine, stool cultures and septic hip arthritis, which made him bed-ridden. The patient improved after combined high dose (according to renal failure) ciprofloxacin (0,8 g/d i.v.) and ceftriaxone (4g/d i.v.) for over 20 days plus cholecystectomy.Conclusions: Successful treatment of recurrent salmonellosis in an immunocompromised patient is based on diligent searching for persistent Salmonella focuses, and prolonged antibiotic treatment.

Keywords: renal failure, recurrent salmonella infection, Wegener’s granulomatosis, septic arthritis, Gallbladder