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Infectious Diseases in Clinical Practice:
doi: 10.1097/IPC.0b013e3182002ddb
Case Reports

Primary Perinephric Abscess Due to Hydrogen Sulfide Producing Variant of Salmonella paratyphi A

Kumar, Anil MD*; K.V., Sanjeevan MS, MCh†; Dinesh, Kavitha R. MD*; Vinod, Vivek MSc*; Karim, Shamsul MD*

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Abstract

A 35-year-old man presented with a gradually worsening left-sided loin pain and high-grade fever 10 days in duration. He gave a history of left flank injury due to a road traffic accident 4 months previously, accompanied by pain and transient mild hematuria that was managed conservatively without further evaluation. Computed tomographic scan revealed undisplaced fracture of the left 10th rib with a large perinephric hematoma/abscess causing significant compression and displacement of the left kidney. The collection was evacuated by open drainage, and its culture yielded a hydrogen sulfide (H2S)-producing variant of Salmonella paratyphi A resistant to nalidixic acid. Blood and urine cultures were sterile. Drainage with culture-specific antibiotics (ceftriaxone followed by cefixime) was curative. Primary perinephric abscess due to S. paratyphi A without any evidence of systemic involvement is rare and classically S. paratyphi A is H2S-negative. We hereby report a case of H2S-positive S. paratyphi A causing primary perinephric abscess of posttraumatic hematoma.

© 2011 Lippincott Williams & Wilkins, Inc.

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