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.
From the *Microbiology and †Urology, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala, India.
Correspondence to: Sanjeevan K.V., Urology, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala 682041, India. E-mail: firstname.lastname@example.org.
Correspondence to: V. Anil Kumar MD, Microbiology, Amrita Institute of Medical Sciences, Ponekkara, Kochi, Kerala 682041, India. E-mail: email@example.com.
The authors have no funding or conflicts of interest to disclose.