Rahul Patel, DO1, Darshan Patel, DO1, Edward Bley, DO2, Varun Chahal, DO1, Marisa Pope, DO2, Seth Lipshutz, DO2, Christopher Chhoun, DO2, Lucy Joo, DO2, Brian Blair, DO, FACG3 1Jefferson Health, Stratford, NJ; 2Jefferson Health, Sewell, NJ; 3Jefferson Health, Cherry Hill, NJ Introduction: Non-typhoidal Salmonella (NTS) is a common bacterial pathogen typically causing self-limited gastroenteritis. Extraintestinal manifestations, such as hepatitis, are rare and usually occur in immunocompromised individuals. We report a case of NTS-induced hepatitis in an immunocompetent 32-year-old male.
Case Description/
Methods: The patient, previously healthy, presented with fever, abdominal pain, diarrhea, and vomiting. Physical examination revealed right upper quadrant tenderness and a small erythematous chest rash. Laboratory results showed elevated liver enzymes (aspartate aminotransferase 807 IU/L, alanine aminotransferase 761 IU/L), leukopenia, and international normalized ratio (INR) 1.27. A viral hepatitis panel, cytomegalovirus, herpes simplex virus, varicella, and other relevant tests were negative, except for past Epstein-Barr virus exposure. Stool studies identified Salmonella and enteroaggregative Escherichia coli, and blood cultures grew Salmonella and Enterobacterales. Imaging, including right upper quadrant ultrasound and computerized tomography (CT) of the abdomen and pelvis, showed no significant findings. The patient was diagnosed with sepsis secondary to Salmonella hepatitis and was treated with intravenous ceftriaxone 2g for 4 days. His liver enzymes improved, and he was discharged on oral cefdinir 300 mg twice daily for a 7-day course Discussion: Salmonella is a Gram-negative bacterium primarily transmitted through contaminated food, particularly undercooked meat, eggs, and produce. While typically causing gastroenteritis, Salmonella can rarely lead to extraintestinal manifestations, including hepatitis, often in patients with underlying liver disease or immunosuppression. The pathophysiology of Salmonella-induced hepatitis is not fully understood but is thought to involve direct bacterial invasion and inflammatory responses triggered by endotoxin release.
The source of the patient’s infection was unclear. A recent cucumber-related outbreak was ongoing, although the patient disliked cucumbers, his family incorporated them into meals but no other family members were symptomatic. The patient had a pet chihuahua but no contact with farm animals or turtles, and no recent international travel. This case highlights the rare occurrence of Salmonella-induced hepatitis in an immunocompetent individual and underscores the need for consideration of extraintestinal manifestations in severe Salmonella infections.
Disclosures: Rahul Patel indicated no relevant financial relationships. Darshan Patel indicated no relevant financial relationships. Edward Bley indicated no relevant financial relationships. Varun Chahal indicated no relevant financial relationships. Marisa Pope indicated no relevant financial relationships. Seth Lipshutz indicated no relevant financial relationships. Christopher Chhoun indicated no relevant financial relationships. Lucy Joo indicated no relevant financial relationships. Brian Blair indicated no relevant financial relationships.
Rahul Patel, DO1, Darshan Patel, DO1, Edward Bley, DO2, Varun Chahal, DO1, Marisa Pope, DO2, Seth Lipshutz, DO2, Christopher Chhoun, DO2, Lucy Joo, DO2, Brian Blair, DO, FACG3. P3497 - Nontyphoid Salmonella-Associated Hepatitis: A Rare Infectious Case, ACG 2025 Annual Scientific Meeting Abstracts. Phoenix, AZ: American College of Gastroenterology.
