Salmonella foodborne infections have been well described. Cardiac complications of Salmonella, including Infective Endocarditis (IE) however are very rare.
Case
50-year-old Hispanic male presented with chest pain, fever & septic shock. Troponin & ECG were unremarkable. Patient was started on empiric antibiotics. Blood cultures grew Salmonella species serotype H&O. TEE confirmed aortic valve vegetation.
Decision-making
Patient denied contact with feces-contaminated food or water with no obvious source of infection and negative immunodeficiency work-up. Therefore, we started looking for other sources of infection. Upon further history taking, patient was found to be regularly consuming dried rattlesnake meat preparations, a rather common practice in the Chihuahua desert region. Surgery was not indicated, and patient was treated with 6 weeks of intravenous antibiotics.
Conclusion
Ingestion of rattlesnake meat has been previously studied in populations residing in the United States- Mexico border region. Few case reports have shown a link between consuming rattlesnake meat with Salmonella bacteremia. We are describing a unique case of Salmonella IE in a patient ingesting rattlesnake meat. This case presents an opportunity for physicians to recognize rare sources of IE by looking deep into cultural exposures and practices.
Slither into the heart: Salmonella endocarditis following rattlesnake meat ingestion
Journal of the American College of Cardiology vol. 75 no. 11
Kunal Mishra, Cameron Cu, Mehran Abolbashari, Jorge D. Guerra, Sclaudia Didia, Chandra Prakash Ojha and Haider Alkhateeb
DOI: 10.1016/S0735-1097(20)33595-6