Salmonella typhimurium pericarditis.

The salmonellae are primarily intestinal pathogens. The clinical picture after infection may vary from gastro-enteritis to "typhoid-like" illness, to intestinal upset followed by septicaemia. This septicaemic phase may localize to produce meningitis, osteitis, pneumonia, focal abscess. In addition, a septicaemic form occurs without any obvious preceding intestinal involvement; this form eventually shows localized lesions. Though myocarditis occurring in the course of typhoid fever has been recognized for many years, endocarditis or pericarditis due to typhoid and other salmonella infections is much less common. In 1947 Shulman collected 17 cases of endocarditis, often superimposed on pre-existing valvular disease, and all fatal. Pericarditis due to Salmonella typhi was apparently well recognized in the 19th century, but has been reported very rarely since. The first case of non-typhoid salmonella pericarditis was described by Cohen, Fink, and Gray (1936). This was a woman of 36 years, who developed pneumonia, pleurisy, and pericarditis, S. choleraesius being recovered from the blood and faeces but not from the pericardial cavity. She recovered, without specific therapy, after a severe illness lasting 10 weeks. In 1961 Levin and Hosier reviewed the published reports, collecting six further cases and adding one of their own. Four of these were children under the age of 2 years, and a total of five cases recovered. The organisms identified were S. typhimurium (4), S. paratyphi A, S. Blegdam, and S. Newport.