Rare Salmonella Infection in Father's Heart: A Critical Medical Case

Q: Rare Salmonella Infection in Father's Heart: A Critical Medical Case

In response to Su Wenting： Based on your description, it may be infectious vasculitis with associated aortic aneurysm. <br>Typically, treatment involves antibiotics for two to four weeks while also managing hypertension. <br>If there is no improvement or if the condition worsens,

My father's right heart vessel is infected with Salmonella, and his condition is critical..?

My father suddenly experienced chest tightness, shortness of breath, and chills around 3:40 PM on August 12.
My mother urgently took him to the New Building Hospital in Tainan.
After examination by the physician, it was suspected that his cardiac vessels were infected, leading to an aortic dilation, which is extremely dangerous.
After discussing with family members, we decided to transfer my father to the intensive care unit at Chi Mei Medical Center in Yongkang, Tainan.
After being admitted to the ICU on August 16, tests confirmed that the infection in my father's cardiac vessels was caused by Salmonella, which is a very rare case.
He was transferred to a general ward on August 20.
However, the physician mentioned that due to considerations for my father's mental state and the stability of his condition (the bacteria are under control), he was allowed to move to a general ward.
Nonetheless, he remains in a critical state and requires careful observation.

Currently, my father's symptoms include: 1.
Regular chest discomfort and pain, with fever during episodes (temperature ranging from 37.9 to 38.9°C).
The chest tightness increases, with episodes lasting about 1 to 3 hours, occurring approximately 1 to 3 times daily.
2.
My father has a history of hypertension and gout, with some recent flare-ups of gout.
The physician's treatment plan for my father, based on my limited understanding, includes antibiotic injections, antipyretics during episodes, and pain relief medications if the pain becomes unbearable.
However, the physician still recommends minimizing the use of pain medications for monitoring purposes.

My father's basic information: born in 1933, height 170 cm, weight approximately 75-85 kg.
We hope that compassionate doctors can provide valuable advice, and our entire family would be immensely grateful!

Su, 60~69 year old female. Ask Date: 2001/08/29

Dr. Ke Zhengchang reply Internal Medicine

In response to Su Wenting: Based on your description, it may be infectious vasculitis with associated aortic aneurysm.
Typically, treatment involves antibiotics for two to four weeks while also managing hypertension.
If there is no improvement or if the condition worsens, surgical intervention by a cardiothoracic surgeon may be necessary.

Reply Date: 2001/08/29

More Info

The case you presented regarding your father's rare Salmonella infection affecting his heart is indeed a critical and complex medical situation. Salmonella is primarily known for causing gastrointestinal infections, but it can also lead to more severe systemic infections, including bacteremia and endocarditis, particularly in individuals with pre-existing health conditions or compromised immune systems.
In your father's case, the sudden onset of chest pain, shortness of breath, and chills suggests an acute cardiovascular event, which was later identified as a Salmonella infection leading to aortic dilation. This condition can be life-threatening as it may lead to aortic dissection or rupture, both of which require immediate medical intervention. The fact that he was transferred to an intensive care unit (ICU) indicates the seriousness of his condition and the need for close monitoring.

The management of a Salmonella infection in the heart typically involves the use of intravenous antibiotics, which is consistent with the treatment your father is receiving. The choice of antibiotics would depend on the sensitivity of the Salmonella strain isolated from his blood cultures. It's crucial to ensure that the infection is adequately controlled to prevent further complications, including the risk of septicemia or the development of abscesses.

Your father's symptoms of recurrent chest pain and fever indicate that while the infection may be under control, he is still at risk for complications. The fluctuating fever (37.9 to 38.9 degrees Celsius) suggests that there may still be an inflammatory process occurring, which could be due to residual infection or an inflammatory response to the infection. The recommendation to avoid pain medications unless absolutely necessary is likely to allow for better monitoring of his symptoms and to avoid masking any signs of deterioration.

Given your father's history of hypertension and gout, it is essential to manage these conditions concurrently. Hypertension can exacerbate cardiovascular issues, and gout flare-ups can complicate his overall health status. The medical team will likely be monitoring his blood pressure closely and may adjust his antihypertensive medications as needed.

In terms of long-term management, once your father's condition stabilizes, further evaluations may be necessary to assess any potential damage to the heart or aorta. This could include echocardiograms to monitor the size of the aorta and any valvular function, as well as follow-up blood cultures to ensure that the infection has been fully eradicated.

It is also important for your family to maintain open communication with the healthcare team. Understanding the treatment plan, potential complications, and the signs of deterioration can empower you and your family to advocate for your father's health effectively.

In conclusion, your father's case is a rare and serious medical condition that requires careful monitoring and management. The use of antibiotics is critical, and the healthcare team will be vigilant in observing his symptoms and adjusting treatment as necessary. It is essential to remain proactive in discussions with his doctors to ensure the best possible outcomes. Your family's support and understanding during this challenging time will be invaluable for his recovery.

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