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Case Reports
. 2019 Aug 28;8(8):2724-2727.
doi: 10.4103/jfmpc.jfmpc_227_19. eCollection 2019 Aug.

Detection of coexisting toxigenic Clostridium difficile and nontyphoidal Salmonella in a healthcare worker with diarrhea: A therapeutic dilemma

Amos Lal  1 , Raul Davaro  2 , Ajay Kumar Mishra  1 , Kamal Kant Sahu  3 , George M Abraham  3
Affiliations
Case Reports

Detection of coexisting toxigenic Clostridium difficile and nontyphoidal Salmonella in a healthcare worker with diarrhea: A therapeutic dilemma

Amos Lal et al. J Family Med Prim Care. .

Abstract

Introduction: Clostridium difficile infection (CDI) and nontyphoidal Salmonella infection (NSI) have similar clinical manifestations and are seldom seen simultaneously. The decision-making in terms of antibiotic therapy becomes difficult when both the pathogens are isolated from the same patient.

Case presentation: We describe a case of Clostridium difficile (CD) enterocolitis in a healthcare provider who concomitantly tested positive for nontyphoidal Salmonella.

Discussion: To the best of our knowledge after extensive literature review (English), this is only the fourth report highlighting this association.

Conclusion: Although Salmonella is not a risk factor for CDI, it can cause intestinal inflammation and alteration in the intestinal flora. When two pathogens are isolated from the same patient, it is tempting to treat both with antibiotics as highlighted. When it involves healthcare workers, there is no difference in guidelines and should not be prescribed antibiotics with intent of reducing secondary transmission.

Keywords: Antibiotics; Clostridium difficile; diarrhea; healthcare worker; nontyphoidal Salmonella.

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Conflict of interest statement

There are no conflicts of interest.

Figures

Figure 1
Figure 1
Axial section of CT scan of abdomen with intravenous contrast showing wall thickening of cecum with adjacent mild inflammatory stranding
Figure 2
Figure 2
(a) Coronal section of CT scan of abdomen with intravenous contrast showing wall thickening of distal small bowel with fluid-filled bowel indicating concurrent enteritis. (b) Axial section of CT scan of abdomen with intravenous contrast showing similar findings as Figure 2(a) in a different plane
See this image and copyright information in PMC

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