SOME UNUSUAL THORACIC COMPLICATIONS OF TYPHOID AND SALMONELLA INFECTIONS

Abstract

Even before the discovery of the typhoid bacillus in 1885, clinicians were aware of pulmonary and pleural complications. It has since been established that Eberthella typhosa and some of the common pathogenic Salmonella spp. produce a variety of thoracic lesions, with minor differences. Among the pulmonary complications produced by both are bronchitis, bronchopneumonia, specific lobar pneumonia, infarction and abscess. The pleural complications include specific pleural effusions which are usually benign but a few of which become pure or mixed-infection empyemata. The former are simply aspirated; the latter require drainage by rib resection. Costal osteochondritis is an uncommon lesion which occurs during or after convalescence. It is characterized by a "cool" abscess which ruptures to form chronic sinuses from the cartilages and ribs. The authors report a case of typhoid empyema with B-P fistula and a case of Salmonella costal chondritis which they have treated. They also report one case each of typhoid osteochondritis, a Salmonella empyema, and an early typhoid empyema, of which the latter was the only fatality. Most of these lesions are amenable to surgery.