Pneumonia in a traveller coming back from Asia

• Published in: Médecine et maladies infectieuses Vol. 38; no. 12; pp. 667 - 670
• Main Authors: Nguyen, S, Baclet, N, Huleux, T, Pasquet, A, Legout, L, Dubreuil, L, Yazdanpanah, Y, Senneville, E
• Format: Journal Article
• Language: French
• Published: France 01-12-2008
• Subjects: Adult; Anti-Bacterial Agents - pharmacology; Anti-Bacterial Agents - therapeutic use; Bacteremia - diagnosis; Bacteremia - drug therapy; Bacteremia - microbiology; Bangladesh; Ceftriaxone - therapeutic use; Drug Resistance, Multiple, Bacterial; Endemic Diseases; Fluoroquinolones - pharmacology; Humans; India; Ketolides - therapeutic use; Male; Paratyphoid Fever - diagnosis; Paratyphoid Fever - drug therapy; Paratyphoid Fever - microbiology; Pneumonia, Bacterial - diagnosis; Pneumonia, Bacterial - drug therapy; Pneumonia, Bacterial - microbiology; Salmonella paratyphi A - drug effects; Salmonella paratyphi A - isolation & purification; Travel
• ISSN: 0399-077X
• DOI: 10.1016/j.medmal.2008.09.020

A case of Salmonella paratyphi A infection was diagnosed late in a patient treated for febrile pneumonia after his returning from India. This case was remarkable in two aspects: first, it illustrated the reemergence of S.paratyphi A infections in people having traveled to India, with increasing fluoroquinolone resistance, and second the difficulty of diagnosing this disease, since the patient was initially treated for pneumonia and flu-like syndrome. Salmonella typhi or paratyphi infections should be evoked in case of persistent fever in patients having traveled to endemic areas, even if digestive signs are absent. Furthermore, choosing an empiric antibiotic treatment with fluoroquinolones could lead to treatment failure if the patient traveled in a country where fluoroquinolone resistance is high, as in Asia and especially in India.