Meor Jamaludin, Wan Husna Barakah and Kamarudin, Norhidayah and Abd Rahni, Ahmad Aizzuddin and Mohamed, Nurdiyana (2025) When typhoid skips the gut: Salmonella Typhi presenting as a submental abscess. In: International Congress of Pathology & Laboratory Medicine (ICPALM) 2025, December 2025, Kuala Lumpur, Malaysia.
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Abstract
Introduction: Salmonella enterica serovar Typhi typically causes enteric fever, with bacteraemia and gastrointestinal involvement. Isolation from extraintestinal sites such as soft tissue abscesses is rare. We report an unusual case of Salmonella Typhi isolated from a submental abscess in a patient with no gastrointestinal symptoms. Case report: A 61-year-old man with underlying uncontrolled diabetes mellitus presented with painful anterior neck swelling for 2 weeks, associated with odynophagia. Examination revealed a fluctuant 7x7 cm submental mass, erythematous with necrotic patch and pus discharge. Pus and tissue cultures yielded pure growth of Gram-negative rod, non-fermenter, positive for O, H and Vi antigen confirmed as Salmonella Typhi. The isolate was susceptible to ampicillin, ceftriaxone, trimethoprim-sulfamethoxazole and ciprofloxacin. He was treated successfully with a combination of surgical drainage and intravenous ampicillin-sulbactam for 10 days. Discussion: Extraintestinal infections due to Salmonella Typhi are uncommon and often associated with predisposing conditions such as diabetes mellitus or immunosuppression. In such cases, haematogenous dissemination from an unrecognised or asymptomatic bacteraemia may seed distant tissues. The absence of gastrointestinal symptoms in our patient highlights the potential for Salmonella Typhi to present atypically, complicating clinical diagnosis. This rare case of Salmonella Typhi in a submental abscess broadens the clinical spectrum of extraintestinal salmonellosis and highlights the importance of microbiological testing in head and neck infections. Prompt culture, targeted antimicrobial therapy, and appropriate surgical intervention remain essential to achieve favourable outcomes.
| Item Type: | Proceeding Paper (Poster) |
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| Additional Information: | 8305/127180 |
| Uncontrolled Keywords: | Salmonella Typhi, Submental abscess, Extraintestinal Typhi, Enteric fever |
| Subjects: | R Medicine > RB Pathology R Medicine > RC Internal medicine R Medicine > RC Internal medicine > RC111 Infectious and Parasitic Diseases R Medicine > RC Internal medicine > RC48.8 Rare diseases R Medicine > RF Otorhinolaryngology |
| Kulliyyahs/Centres/Divisions/Institutes (Can select more than one option. Press CONTROL button): | Kulliyyah of Medicine Kulliyyah of Medicine > Department of Pathology & Lab Medicine Sultan Ahmad Shah Medical Centre (SASMEC) |
| Depositing User: | Dr. Wan Husna Barakah Meor Jamaludin |
| Date Deposited: | 05 Feb 2026 09:57 |
| Last Modified: | 05 Feb 2026 17:10 |
| Queue Number: | 2026-01-Q1937 |
| URI: | http://irep.iium.edu.my/id/eprint/127180 |
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