SALMONELLOSIS AND ULCERATIVE COLITIS: COINCIDENCE?

TOPIC: Critical Care TYPE: Medical Student/Resident Case Reports INTRODUCTION: Infectious and inflammatory colitis such as salmonella enterocolitis ulcerative rarely coexist in the same individual. While often self-limiting, certain pathogens a non-typhoid can contribute to significant morbidity mortality patients with underlying colitis. Prompt recognition treatment is important these order improve outcomes. CASE PRESENTATION: A 55-year-old female prior diagnosis of (non- biopsy proven) had been treated steroids mesalamine by her primary care provider over past 2 years. She presented emergency department complaints worsening watery, non-bloody diarrhea- roughly 5-15 episodes day, associated nausea vomiting. denied consuming raw food or outside home cooked meals. Laboratory work revealed white blood cell count 5700 cells/cumm 30% bands lactic acid 2.5 mmol/L. CT imaging abdomen pelvis diffuse, nonspecific involving entirety colon. Clostiroides difficile toxin was negative. started resuscitated crystalloids cefepime metronidazole. The cultures positive gram-negative rods 4/4 bottles. patient remained persistently hypotensive despite fluid resuscitation, hence transferred intensive unit on vasopressor medications. Her pressor requirements continued increase. As did count. evaluated surgical team underwent total colectomy that evening. Blood eventually speciated pan-sensitive Salmonella antibiotics were deescalated ceftriaxone alone. Following surgery, able be weaned off vasopressors clinical condition improved significantly. tolerate regular diet discharged course levofloxacin. Pathology from specimen chronic ulceration regenerative gland formation, suggestive DISCUSSION: Coincidence salmonellosis rare problem. infection has reported complicate colitis, either facilitating its occurrence activation. These rapidly decompensate, thus require aggressive management. When fail pressure support alone, intervention must considered especially cases which bowel disease also key factor. CONCLUSIONS: potential cause hospitalized With prompt treatment, outcomes for significantly improved. REFERENCE #1: Navaneethan U, Giannella RA. Curr Opin Gastroenterol. 2011 Jan;27(1):66-71. doi: 10.1097/MOG.0b013e3283400755. PMID: 20856114. #2: DuPont HL. Approach infectious 2012 Jan;28(1):39-46. 10.1097/MOG.0b013e32834d3208. 22080825. #3: Azer SA, Tuma F. Colitis. [Updated 2020 Sep 27]. In: StatPearls [Internet]. Treasure Island (FL): Publishing; 2021 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK544325/ DISCLOSURES: No relevant relationships Neetha Mathew, source=Web Response Kevin Nowakowski, Navitha Ramesh,