Salmonella colitis or inflammatory bowel disease? A case demonstrating overlapping of clinical, endoscopic and pathologic features

Abstract

SUMMARY
Inflammatory bowel disease and gastroenteritis secondary
to Salmonella infection may manifest with overlapping clinical,
endoscopic and histologic features. The case reported
is of a 70-year-old woman who was admitted to hospital due
to fever and diarrhea. Colonoscopic findings were suggestive
of Crohns disease, however pathologic examination
when based on crypt architecture and presence of an acute
neutrophilic inflammatory infiltrate in the lamina propria,
was not diagnostic of either Crohns disease or acute self
limited colitis. Stool cultures were positive for Salmonella
and treatment with antibiotics was begun, followed by the
patients clinical improvement. Repeat colonoscopy was
performed a few days later and endoscopic findings demonstrated
marked improvement. Pathologic examination of
biopsies this time were compatible with Crohns disease,
particularly evaluating the formation of microgranulomas
as well as basal lymphoid hyperplasia and basal lymphoid
aggregates.
Key words: Inflammatory bowel disease, Salmonella infection,
endoscopy, pathology