Abstract • Three Hispanic patients at our institution developed extragastrointestinal Salmonella arizona infection associated with the ingestion of rattlesnake capsules. All patients had underlying chronic medical illnesses, including the acquired immunodeficiency syndrome, systemic lupus erythematosus, and congestive heart failure. Rattlesnake capsules were obtained from both local pharmacies and patients. Salmonella arizona, as well as various other enteric organisms, was grown on cultures obtained from all capsules tested. Review of the literature disclosed three additional cases of extragastrointestinal S arizona infection linked to rattlesnake capsule ingestion, all associated with underlying medical illness. We postulate that rattlesnake capsules may be frequently ingested by chronically ill Hispanic individuals and serve as a vehicle for serious S arizona infection. (Arch Intern Med 1988;148:1207-1210) References 1. Winter E: Mexico's Ancient and Native Remedies . Mexico City, Editorial Fournier, 1968, pp 18-82. 2. Marzouk JB, Joseph P, Lee TJ, et al: Arizona hinshawii septicemia associated with rattlesnake powder. Calif Morbidity , (July 1) , 1983, p 25. 3. Fainstein V, Yancey R, Trier P, et al: Overwhelming infection in a cancer patient caused by Arizona hinshawii: Its relation to snake pill ingestion. Am J Infect Control 1982;4:147-153.Crossref 4. McIntyre KE, Malone JM, Richards E, et al: Mycotic aortic pseudoaneurysm with aortoenteric fistula caused by Arizona hinshawii. Surgery 1982;91:173-177. 5. Ewing WH: The genus Salmonella , in Edwards and Ewing's Identification of Enterobacteriaceae . New York, Elsevier Science Publishing Co Inc, 1986, pp 181-233. 6. Kelly MT, Brenner DJ, Farmer JJ: Enterobacteriaceae , in Lennette EH, Balows A, Hausler WJ, et al (eds): Manual of Clinical Microbiology , ed 4. Washington, DC, American Society for Microbiology, 1985, pp 263-277. 7. Caldwell ME, Ryerson DL: Salmonellosis in certain reptiles. J Infect Dis 1939;65;242-245.Crossref 8. Edwards PR, Chemy WB, Bruner DW: Further studies on coliform bacteria serologically related to the genus Salmonella. J Infect Dis 1943;73:229-238.Crossref 9. Guckian JC, Byers EH, Perry JE: Arizona infection of man. Arch Intern Med 1967;119:170-175.Crossref 10. Krag D, Shean DB: Serious human infection due to bacilli of the Arizona group. Calif Med 1959;90:230-233. 11. Black PH, Kunz LJ, Swartz MN: Salmonellosis: A review of some unusual aspects. N Engl J Med 1960;262:811-817, 864-869, 921-927.Crossref 12. Wolfe MS, Armstrong D, Louria DB, et al: Salmonellosis in patients with neoplastic disease: A review of 100 episodes at Memorial Cancer Center over a 13-year period. Arch Intern Med 1971;128:546-554.Crossref 13. Bennett IL, Hook EW: Infectious diseases (some aspects of salmonellosis). Ann Rev Med 1959;10:1-19.Crossref 14. Armstrong D, Gold JWM, Dryjanski J, et al: Treatment of infections in patients with the acquired immunodeficiency syndrome. Ann Intern Med 1985;103:738-743.Crossref 15. Revision of CDC surveillance case definition for AIDS. MMWR 1987;36:15. 16. Weiss SH, Blaser MJ, Paleologo FP, et al: Occurrence and distribution of serotypes of the arizona subgroup of Salmonella strains in the United States from 1967 to 1976. J Clin Microbiol 1986;23:1056-1063.
Archives of Internal Medicine – American Medical Association
Published: May 1, 1988
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