Invasive nontyphoidal Salmonella infection in a patient with Roux-en-Y gastric bypass and gastrostomy tube: a case report

BACKGROUND: Infections with nontyphoidal Salmonella most commonly cause a self-limited gastroenteritis in humans and are the leading source of foodborne illness. In the USA, the incidence of culture-confirmed invasive Salmonella is extremely rare. Here, we present a unique case of enteric nontyphoidal Salmonella enteritidis infection that progressed to an invasive bacteremia in a patient with Roux-en-Y gastric bypass and gastrostomy feeding tube. CASE PRESENTATION: A 58-year-old Caucasian woman with a past medical history of Roux-en-Y gastric bypass with revision and recent gastrostomy feeding tube insertion was admitted with fever and diarrhea. During her inpatient stay, two sets of blood cultures grew Salmonella enteritidis and she was promptly treated with intravenous antibiotics. Her hospital course was also complicated by acute kidney injury. The patient recovered after treatment with a third-generation cephalosporin and supportive treatment. CONCLUSION: We present an unusual case of nontyphoidal Salmonella enteritidis bacteremia complicated by acute kidney injury in a middle-aged woman with a previous history of Roux-en-Y gastric bypass and gastrostomy feeding tube insertion. Further investigation is needed to identify whether gastric surgeries or procedures are independent risk factors for invasive nontyphoidal salmonellosis.