Article in Japanese

A case of Salmonella related hemorrhagic cystitis complicated by bacteremia in an 8-year-old boy with a history of keeping reptiles

Takumi Moriuchi^1）, Masato Oshiro^1）, Kazuyo Murayama^1）, Yoshitsune Miyagi1）, Rieko Higa1）, Makoto Sunagawa1）

This study reports a case of hemorrhagic cystitis and bacteremia due to non-typhoidal Salmonella （NTS） in a previously healthy 8-year-old boy with a history of reptile exposure. The boy was admitted to hospital with fever, gross hematuria, and dysuria, and antibiotic treatment was initiated for a suspected urinary tract infection. Salmonella enterica subsp. enterica serovar Oranienburg was detected in a blood culture the day after admission, and the same serovar was identified in a urine culture the following day. Imaging studies revealed bladder wall thickening, but no other abnormalities were observed. After the blood culture turned negative, the patient received a 2-week course of antibiotics and was discharged. NTS urinary tract infections are rare, and there have been few detailed reports of pediatric cases with bacteremia. Serotyping of the boy’s urine and blood isolates and fecal samples from his pet reptiles was performed, but no matches were found, and the exact route of infection could not be determined. However, as the boy had no other apparent risk factors for NTS infection, and reptiles can carry multiple NTS strains, zoonotic origin from the boy’s pet reptiles was suspected. Although the number of reported foodborne NTS infections in Japan is declining, recent reports from Europe, the United States and Australia have raised concerns about an increase in reptile-associated NTS infections, particularly among children. Going forward, healthcare professionals must be more vigilant regarding zoonotic infections and strengthen public education and awareness.

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1）Department of Pediatrics, Keiaikai Nakagami Hospital

Key words	Salmonella, hemorrhagic cystitis, bacteremia, zoonotic infections
Received	March 8, 2025
Accepted	May 12, 2025

37 (3)：238─245,2025