چکیده (انگلیسی):

Introduction: Non-typhoidal Salmonella (NTS) is mostly restricted to gastroenteritis; however, we report
a case of Salmonella pericarditis complicated by tamponade and spontaneous ventricular wall rupture.
Case presentation: A 67-year-old male presents to the Emergency Department with complaints of fevers,
chills and body aches. A chest radiograph displayed an infiltrate and an electrocardiogram suggested
acute pericarditis. An echocardiogram revealed a small pericardial effusion without tamponade. Broadspectrum
antibiotics were initiated until Salmonella was discovered in blood cultures. The hospital
course was complicated by sudden decompensation, and a repeat echocardiogram displayed a large
effusion with constrictive physiology. During a pericardial window, the tissue was noted to have a
thickened appearance with a complex effusion. The following day, the patient developed increased chest
tube drainage, hypotension and acidosis, requiring an emergent sternotomy. The right ventricle was
friable and had spontaneously ruptured. After ventricular repair and pericardiectomy, the tissue was sent
for cultures and pathology. The specimen revealed Salmonella enteriditis. Treatment with ceftriaxone
and ciprofloxacin was initiated. On postoperative day four, the patient was successfully extubated. Repeat
blood cultures were negative.
Discussion: In our review of literature, only 19 cases of NTS pericarditis have been reported. Prior to our
case, salmonellosis resulting in ventricular rupture has been reported once. Early diagnosis and treatment
is crucial in minimizing morbidity and mortality. Clinical suspicion based on electrocardiogram and
hemodynamic assessment is critical in suspecting pericardial effusion in a patient with nonspecific
symptoms and Salmonella bacteremia. The key to recovery involves aggressive treatment, including
pericardiectomy and antibiotic treatment.