Salmonella infection as a trigger for Polyarteritis Nodosa

Authors

• Pedro Neves Tavares Department of Internal Medicine 1, Centro Hospitalar de Leiria, Leiria, Portugal
• Patricia Alves Department of Internal Medicine 1, Centro Hospitalar de Leiria, Leiria, Portugal
• Rita Lizardo Grácio Department of Internal Medicine 1, Centro Hospitalar de Leiria, Leiria, Portugal
• Paula Gonçalves Costa Department of Internal Medicine 1, Centro Hospitalar de Leiria, Leiria, Portugal
• Carla Falcão Department of Internal Medicine 1, Centro Hospitalar de Leiria, Leiria, Portugal
• Catarina Duarte Santos Department of Internal Medicine 1, Centro Hospitalar de Leiria, Leiria, Portugal
• Filipa Amado Department of Internal Medicine 1, Centro Hospitalar de Leiria, Leiria, Portugal

pedronevestavares@gmail.com

Keywords

Abstract

Polyarteritis nodosa is a systemic necrotizing vasculitis that typically affects medium-sized muscular arteries, with occasional involvement of small muscular arteries. Most cases of polyarteritis nodosa are idiopathic but multiple infectious agents have been associated with this disease. We present a clinical case of a 72-year-old male with fever, diarrhoea and haemodynamic instability, diagnosed with a bacterial infection caused by Salmonella Typhi. One week after clinical resolution of the infection, the patient developed purpuric lesions with ulcers, pustules and necrotic areas accompanied by testicular pain and weight loss of 5 kg over the previous 15 days. A skin biopsy was performed and it revealed typical histologic signs of polyarteritis nodosa. The aetiologic association between bacteria of the genus Salmonella and polyarteritis nodosa has been previously described in the scientific literature but seldom meeting classification criteria and with histologic confirmation.