Empyema in Enteric Fever Due to Salmonella Paratyphi B

¹ Department of Medicine, Madras Medical College and General Hospital, Madras, India

Salmonella Paratyphi B is a rare cause of empyema. Empyema in enteric fever may be a primary manifestation of the bacteremic stage or may be secondary to a primary focus. The infection can spread from adjacent areas such as infected cartilage, rib, lung, liver, parasternal node and subdiaphragmatic abscess or from a distant site such as perforation of small intestine. As a presenting manifestation, empyema is easy to recognize, but when it is overshadowed by toxemia or complications, the diagnosis may be difficult or missed. With chloramphenicol therapy the systemic manifestations abate but control of the effusion requires repeated aspiration, local instillation of chloramphenicol, steroids, proteolytic enzymes and sometimes open drainage. Fluid in the pleural space which is initially serous or serosanguineous becomes purulent later. Organisms isolated from the empyema fluid in an attenuated form have a high antigenic potency.