Abstract
Salmonella neck infections represent an uncommon cause of focal salmonellosis. While the incidence of nontyphoid salmonellosis is estimated at over 2 million cases annually, extraintestinal manifestations account for less than 1% of cases. This paper describes two patients with Salmonella neck abscesses as the initial presentation of diabetes mellitus. The first patient was diagnosed as having Salmonella enterica serotype Enteritidis sternocleidomastoid pyomyositis and the second patient Salmonella enterica serotype Typhimurium parapharyngeal abscess. Both patients had elevated hemoglobin A1c levels and had not been previously diagnosed with diabetes mellitus. Salmonella spp. should be on the differential as a causative pathogen in patients presenting with neck abscesses and poorly controlled glucose levels. Diabetes may be a risk factor for salmonellosis due to decreased gastric acidity and prolonged gastric transit time. Prompt incision and drainage accompanied by antibiotics remains the treatment of choice for infected neck abscesses.
Highlights
Salmonella infections are typically classified into four categories: gastroenteritis, enteric fever, focal disease, and chronic carrier state
Focal salmonellosis is thought to be secondary to a brief episode of bacteremia after infection from the GI tract
The median age, rate of underlying conditions, and mortality in patients with Salmonella muscle infections are significantly higher than those patients presenting with pyomyositis involving other microorganisms [3]
Summary
Salmonella infections are typically classified into four categories: gastroenteritis, enteric fever, focal disease, and chronic carrier state. Patients with significant underlying conditions are at increased risk for the development of focal infection. This has been observed in patients with HIV, diabetes, and malignancy [1]. Pyomyositis, an intramuscular abscess of skeletal muscle, was first described in the tropics. The median age, rate of underlying conditions, and mortality in patients with Salmonella muscle infections are significantly higher than those patients presenting with pyomyositis involving other microorganisms [3]. We present a case of sternocleidomastoid pyomyositis caused by Salmonella enterica serotype Enteritidis, as well as a parapharyngeal space abscess caused by Salmonella enterica serotype Typhimurium in two patients newly diagnosed with uncontrolled diabetes mellitus
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