A Fatal Case of Acute Enteritis Caused by Salmonella Weltevreden after Travel to Indonesia

Abstract

A 67-year-old male was admitted to our hospital because of watery diarrhea and pre-shock status at 10: 30 am on March 20, 1995. He had travelled to Bali Island in Indonesia from March 13 to March 18, 1995. On admission, his systolic blood pressure was 60 mmHg and body temperature was 35.2°. His skin was very dry. Laboratory tests showed that s-Cr was 6.3 mg/dl and CPK was 5620 IU/1. A massive fluid transfusion was given immediately and then his blood pressure rose to 158/92 about two hours after admission. Howerver, he developed a high gradefever and systemic cyanosis in the evening of the first hospital day and died at 0: 20 am on March21st. Salmonella Weltevreden was detected in the fecal and blood cultures obtained on admission.
We considered that his acute renal failure was attributable to rhabdomyolysis due to dehydration and that the cause of death was probably septic shock. The patient had a previous history of cholecystectomy ten years ago and also suffered from hypertension, but his general condition was not so bad before this episode. Therefore, we were surprised that his illness becameso severe.T
his case emphasizes that Salmonella enteritis may occasionally be a serious and lethal disease.