Salmonella: The gift that keeps on giving

We report a case of chronic infection caused by Salmonella and cured by a laparoscopic cholecystectomy after Roux-en-Y gastric bypass (RYGB) surgery for obesity. This patient presented with a 2-year history of chronic abdominal pain, loose stools and excessive weight loss. Her stool and urine cultures were positive for Salmonella. Despite multiple courses of antibiotics, she remained positive.

After undergoing a laparoscopic cholecystectomy, the patient became asymptomatic and stools remained negative. In chronic carriers for Salmonella, the gall bladder is the common reservoir for the bacteria and removing it is usually curative.

The possibility that the source of the may be in the biliary limb of her bariatric procedure and not in the gall bladder remained a concern.

In patients who have had a RYGB, cholecystectomy is an effective treatment.

All patients presenting with abdominal symptoms following RYGB should have stool and urine cultures taken as part of their work up.

A case of a chronic slamonella infection following Roux-en-Y gastric bypass surgery, treated successfully by a laparoscopic cholecystectomy

MBJ Case Reports, 2017, Zohaib Siddiqui, Zain Ahmed Siddiqui, Fahd Husain, Midhat Siddiqui, doi:10.1136/bcr-2017-219395

http://casereports.bmj.com/content/2017/bcr-2017-219395.short?rss=1

This entry was posted in Salmonella and tagged , , , by Douglas Powell. Bookmark the permalink.

About Douglas Powell

A former professor of food safety and the publisher of barfblog.com, Powell is passionate about food, has five daughters, and is an OK goaltender in pickup hockey. Download Doug’s CV here. Dr. Douglas Powell editor, barfblog.com retired professor, food safety 3/289 Annerley Rd Annerley, Queensland 4103 dpowell29@gmail.com 61478222221 I am based in Brisbane, Australia, 15 hours ahead of Eastern Standard Time