University of Minnesota, Minneapolis, USA
Received date: April 03, 2014; Accepted date: July 05, 2014; Published date: August 10, 2014
Citation: Mohamed M, Asnis D (2014) A Geriatric Breast Abscess due to Salmonella enteritidis. Clin Microbial 3:164. doi: 10.4172/2327-5073.1000164
Copyright: © 2014 Mohamed M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
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Breast abscesses occur most commonly during pregnancy and lactation. However, increasing numbers of breast abscesses are being reported in non-lactating patients as well . Salmonella typhi can cause breast abscess infrequently and have been reported in up to 0.9% of S. typhi infections . Non-typhi isolates of Salmonella are even rarer .
Breast abscess; Salmonella; Breast Implants; Geriatric
A 66 year old Liberian woman presented with a one week history of weakness, polydipsia, polyuria and poor appetite along with a right breast swelling without fever or chills. She denied diarrhea, trauma or recent illness. She had a history of breast cancer and underwent a lumpectomy; subsequently she had bilateral breast implants with silicone over twenty years ago. Examination revealed: temperature 39.3°C and a right breast that was fluctuant and red with purulent nipple discharge without axillary lymphadenopathy. Laboratory results revealed: WBC 17x10/L and glucose 557 mg/dl. An incision and drainage of the right breast abscess and implant removal were done. Abscess fluid grew Salmonella enteritidis. Blood, stool and urine cultures were negative. She was treated with two weeks of levofloxacin.
Localized infection occurs from overt or occult bacteremia with seeding a distant site, often with preexisting disease . Risk factors may include: malignancy , local trauma , and hematoma . Isolated breast abscess from S. enteriditis infection has not been reported in a nonpuerperal geriatric woman with a breast implant. Our patient did not have any evidence of a recurrence of her breast cancer. Previously seven cases of non-typhi breast abscesses have been reported (3 infants and 4 adults) [4-7]. Three of the four adults were related to pregnancy. None were older than forty years. Our case had several unique features: no antecedent illness, no animal contact or recent travel. It also serves as a reminder that breast masses may not always be malignant prompting microbiologic evaluation.