Cholecystitis and subphrenic abscess caused by Salmonella virchow.

Introduction Infection of the gall-bladder is well described and occurs almost invariably in enteric fever caused by Salmonella typhi. Despite this, however, symptoms of acute cholecystitis occur in only 2% of cases (Stuart and Pullen, 1946). Systemic invasion is a much rarer sequel of infection with food poisoning Salmonella, and this has been associated with certain types, e.g. S. choleraesuis. But, if systemic invasion does occur, focal infection in almost any organ may result. In a review of clinical syndromes associated with non-typhoidal Salmonella infection (Sapra and Winter, 1957) only 146 of 7779 (1-9%) cases had focal infection directly or indirectly related to the gastrointestinal tract. Non-typhoidal salmonellae are a rare cause of infective cholecystitis, being responsible for 0-6% of the cases of Fukunaga (1973) and none of those of Keighley and Graham (1973); they are an equally rare cause of subphrenic abscess (Dineen and McSherry, 1962). The authors therefore report a case of cholecystitis complicated by a subphrenic abscess caused by S. virchow.