Salmonella typhi bacteriuria,predispositions and complications-two case reports and review of literature

Abstract

Aims Salmonella typhi infection presents most commonly as typhoid fever. Infection can less commonly manifest as extraintestinal localize infections of bone, joints, soft tissues, spleen, endocarditis,pulmonary, hepatobiliary, genital and urinary systems. UTI is rare and clinical presentation is indistinguishable from UTIs due to other etiological agents or may even be asymptomatic. Relapses and a chronic course with coexisting functional or structural abnormalities of the urinary tract system should raise the suspicion of Salmonella as oneof the probable causative agents. Methods We report two cases of patients with chronic kidney disease with urinary tract infection due to Salmonella typhi and same organism was isolated additionally from the DJ stent and stones in one of them. Results Renal cyst, nephrolithiasis and urethral strictures were the concomitant findings in onecase and renal tubular acidosis with nephrocalcinosis in the other. Conclusions In patients with co-existing renal findings Salmonella should be kept in mind so as to ensure appropriate and adequate therapy. Also in the presence of long standing hypokalemia one must investigate for renal causes.