Isolation of Salmonella enterica ssp. diarizonae in clinical samples: A diagnostic dilemma
Journal Title: International Journal of Medical and Health Sciences - Year 2015, Vol 4, Issue 3
Abstract
A twelve years old boy was admitted in a tertiary care hospital in January, 2015 with history of cough with expectoration, chest pain and fever respectively. On examination, all his vital parameters were normal except low grade fever. No abnormality was detected on systemic examination except slightly reduced air entry in right lung fields. His chest X-ray revealed consolidation of right lung fields with blunting of right costo-phrenic angle. A CT scan of chest was immediately performed which revealed collection of fluid in right pleural cavity and pleural tapping revealed frank pus. Subsequently, a chest drain was placed for the drainage of pleural fluid. Pleural fluid was subjected to culture and sensitivity. Two different organisms namely Salmonella enterica ssp. diarizonae and Escherichia coli were identified by VITEK-2 automated system. Keeping in mind the rare possibility of human infection caused by Salmonella enterica ssp. diarizonae, this isolate was subjected to conventional biochemical identification tests and eventually identified as a different strain of Escherichia coli. The patient was successfully treated and discharged from the hospital after one week. To conclude, we would like to emphasize on the fact that identification by automated systems of bacterial isolates in clinical samples as Salmonella enterica ssp. diarizonae does not necessarily mean that it is the causative organism. Such bacterial isolates must be subjected to conventional biochemical identification methods. Laboratories should consider several possibilities such as specimen contamination, incorrect identification by automated systems and contamination of sheep blood agar before ascertaining pathogenic status to this organism.
Authors and Affiliations
Mohit Bhatia, Archana Thakur, Bimbadhar Rath, Bibhabati Mishra, Vinita Dogra
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