extraintestinal site has the highest propensity for nntyphoidal Salmonella bacteremia

Q: Which of the following extraintestinal sites has the highest propensity for nontyphoidal Salmonella bacteremia? - select one

A) Heart valves

B) Endovascular  

C) Meninges 

D) Bone

E) Pancreas 

Answer: B

Nontyphoidal Salmonella bacteremia has a propensity to localize to atherosclerotic or pre-existing vascular disease in large vessels, particularly in older and immunosuppressed patients. 

The infrarenal aorta is the most frequent site of vascular infection. Other common sites include the thoracic aorta and other central arterial sites, characterized by fever (usually subacute), abdominal pain, and back pain, and are associated with relapsing or prolonged Salmonella bacteremia.

CNS infections are followed by endovascular infection, particularly in children. Other sites, as mentioned in the question above, are also possible but rare.

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References:

1. Hsu RB, Lin FY. Risk factors for bacteraemia and endovascular infection due to non-typhoid salmonella: a reappraisal. QJM 2005; 98:821.

2. Benenson S, Raveh D, Schlesinger Y, et al. The risk of vascular infection in adult patients with nontyphi Salmonella bacteremia. Am J Med 2001; 110:60.

3. Chen SY, Weng TH, Tseng WP, et al. Value of blood culture time to positivity in identifying complicated nontyphoidal Salmonella bacteremia. Diagn Microbiol Infect Dis 2018; 91:210.