CASE REPORT: Necrotizing Acute Pancreatitis Induced by Salmonella typhimurium

Salmonella is a gram-negative, non-spore-forming, motile, facultatively anaerobic bacillus. It may present with gastroenteritis, enteric fever, bacteremia, or as an asymptomatic carrier state. Typhoid fever is most commonly caused by S. typhi and S. paratyphi. Enteric fever is more common in developing countries and is rarely seen indigenously in the United States. It is transmitted via fecal–oral contamination of water and food and is characterized by prolonged fevers, abdominal pain, diarrhea, intestinal bleeding, rose spots, and splenomegaly. Nontyphus Salmonella (S enteritidis and S typhimurium most commonly) account for about 2.3% of gastroenteritis cases in the United States, or 2–4 million cases annually. They are most often associated with poultry and eggs and may also be seen with meat and dairy products. The spectrum of disease of nontyphus Salmonella ranges from mild to choleralike. Fever, abdominal cramping, nausea, vomiting, or chills may also be present. The disease is seen as a complication of other diseases such as AIDS, cirrhosis, diabetes, malaria, and sickle cell anemia. Unusual manifestations include osteomyelitis, aneurysms, meningitis, and appendicitis. Salmonella pancreatitis is a rare entity that has also been reported. Here we describe a case of an even rarer association of S. typhimurium causing a necrotizing pancreatitis.