Is Salmonella Infection Another Possible Trigger for Polyart
Polyarteritis nodosa is a systemic necrotizing vasculitis associated with a multitude of aetiologic agents. Salmonella infection might be a possible trigger for the development of polyarteritis nodosa.

A high index of suspicion and awareness is essential for a swift diagnosis and treatment of this disease.

Researchers present a clinical case of a 72-year-old male with fever, diarrhoea and haemodynamic instability, diagnosed with a bacterial infection caused by Salmonella Typhi. One week after clinical resolution of the infection, the patient developed purpuric lesions with ulcers, pustules and necrotic areas accompanied by testicular pain and weight loss of 5 kg over the previous 15 days. A skin biopsy was performed and it revealed typical histologic signs of polyarteritis nodosa.

The patient was treated with prednisolone, starting with 60 mg followed by progressive dose reduction, with complete remission of the skin lesions.

There is biologic plausibility to the association of bacterial infection by the genus Salmonella and the development of polyarteritis nodosa. The interaction of bacteria of the genus Salmonella and Peyer’s patches leads to the induction of a T-cell response and production of IgM, IgG and IgA by B cells. This patient meets the American College of Rheumatology classification criteria for polyarteritis nodosa and the clinical signs of the disease appearing 3 weeks after the Salmonella infection suggests a temporal association.