But what was the "chunky, meat like substance"?

Why last night’s chicken made you sick.

This is an excellent article about the lawyer who made the beed industry work to stop E. coli contamination. I was struck by the opening story about Mr. Schiller and his infection from Salmonella Heidelberg. The description of his symptoms is intense. But what was going on here? What was his leg full of?

Salmonella infections in 2014 came from many different sources including the usual suspects raw chicken, eggs and sprouts but also from pet reptiles and vegan cheese

Salmonella is a bacteria and is related to  E. coli. These cousins are responsible for a huge amount of food poisoning. Salmonella Heidelberg is resistant to multiple general antibiotics and while it can cause moderate gastrointestinal issues it can also cause blood poisoning (septicemia or bacteremia), heart inflammation (which can lead to a heart attack), and death. SHeidelberg is a partially invasive and mean member of the Salmonellas and while not responsible for most of the of food poisoning cases, it's responsible for the most serious enteric infections. 

So what could this discharge be? I'm thinking it could be one of two things. Or both!  It could be osteomyelitis which can be caused by Salmonella. Osteomyelitis, however, is most often diagnosed radiologically. Infection of the leg bone would have localized inflammation and swelling but would that appear as a "chunky, meatlike substance"? 

ow about muscle infection? I found several case studies that outlines swelling in muscle tissue of the leg, pus drainage and often debridement of the leg to remove infection. While none of the case studies mention a  "chunky, meatlike substance" they do mention high neutrophil counts which is, literally, the stuff of pus. Bacteria laden blood mixed with pus could form a thick, hard to aspirate "chunky, meat like substance." I'm guessing this is the likely candidate. More research required!

Unfortunately, advanced muscle infection cases are often treated with tissue debridement. I hope Mr. Schiller had a quick recovery. 

References: 

  • Burt, Carolyn R., et al. "Fatal myocarditis secondary to Salmonella septicemia in a young adult." The Journal of emergency medicine 8.3 (1990): 295-297.
  • Vugia, Duc J., et al. "Invasive Salmonella infections in the United States, FoodNet, 1996–1999: incidence, serotype distribution, and outcome." Clinical infectious diseases 38.Supplement 3 (2004): S149-S156.
  • Nayak, R., and P. B. Kenney. "Screening of Salmonella isolates from a turkey production facility for antibiotic resistance." Poultry science 81.10 (2002): 1496-1500.
  • Chittick, Paul, et al. "A summary of national reports of foodborne outbreaks of Salmonella Heidelberg infections in the United States: clues for disease prevention." Journal of Food Protection® 69.5 (2006): 1150-1153.
  • Collazos, Julio, et al. "Muscle infections caused by Salmonella species: case report and review." Clinical infectious diseases 29.3 (1999): 673-677.
  • Collazos, Julio, et al. "Comparison of the clinical and laboratory features of muscle infections caused by Salmonella and those caused by other pathogens." Journal of infection and chemotherapy 7.3 (2001): 169-174.
  • Pastagia, Mina, and Stephen G. Jenkins. "Salmonella Neck Abscess as an Opportunistic Infection in Diabetes Mellitus." Case reports in infectious diseases2013 (2013).
  • Björkman, Per, Anna Nilsson, and Kristian Riesbeck. "A pilot with pain in his leg: thigh abscess caused by Salmonella enterica serotype Brandenburg." Journal of clinical microbiology 40.9 (2002): 3530-3531.
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