An autopsied case of septicemia and benign thymoma with abscess due to Salmonella typhi murium is described. An 81 year-old male was admitted because of high fever. He had been under treatment for chronic hepatitis for the past 4 years. The fever continued despite antibiotics with considerable fluctuation. There were spider angiomata, and the chest X-ray disclosed a large mass in the left thorax, occupying about 2/3 of the lung field. The leukocyte count was normal, and the liver function disorder was not remarkable except a slight retention of BSP. Cultures of blood and feces on several occasions grew out Salmonella typhi murium. The Widal test was moderately positive for paratyphoid B.
He succumbed on the 24th hospital day. The autopsy revealed a child head sized thymoma with a hen egg size abscess and several smaller ones. The same organisms were isolated from the abscess. The bowels were almost normal except for a mild inflammation in the small intestine. The liver was cirrhotic, and the spleen weighed 75 grams.
This case represents a rare clinical feature of Salmonella typhi murium infection in that overwhelming septicemia is generally uncommon, and that the pre-existing neoplasm was the site of abscess formation.
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