Abstract 63-year-old female presented to the emergency department with fatigue, multiple falls and diarrhoea. Her background history is significant for hypertension, depression, hyperlipidemia and chronic back pain. She is a lifelong smoker with a 40-pack year smoking history. On admission, she was tachycardic, febrile and had on oxygen requirement. She was admitted as a case of acute diarrhoea and multiple falls. Her blood cultures taken on admission grew Salmonella Cholerae-suis in both bottles. Her stool cultures subsequently grew Salmonella Cholerae-suis. Microbiology advice was sought out and IV Piperacillin-Tazobactam was commenced.As Salmonella bacteremia is rare in an immunocompetent adult, Microbiology advised to investigate potential causes for immunosuppression including malignancy. She had a chest-xray showing a right upper lobe mass, and CT subsequently confirmed 3.2 cm right upper lobe mass suspicious for a primary lung cancer. She was tested for HIV which came back negative. She improved on the IV Piperacillin-Tazobactam and remained afebrile throughout her admission.During her admission, she was then investigated for potential lung cancer. Her CT abdomen pelvis showed no metastases. Her MRI Brain also was normal. She subsequently underwent PET CT scan in Cork University Hospital. Her PET CT scan showed an FDG avid (SUV of 12.6) mass at the right upper lobe with mildly avid paratracheal nodes. An EBUS was performed and she was confirmed to have a non-small cell lung cancer. Discussion There are approximately 2000 serovars of non-thypoidal Salmonella that can cause gastroenteritis. However, salmonella bacteremia is rare, which prompted clinicians to look for underlying cause of immunosuppression such as underlying malignancy or immunodeficiencies. Figure 1 PET CT scan showing an FDG avid right upper lobe mass This abstract is funded by: N/A
Azman et al. (Fri,) studied this question.