Fitzgerald, Mark

Kamath, Sheshang

2024-10-23

Testicular tumours can present outside the testis in about 5 % of cases, including as a primary lesion within the retroperitoneal space. These arise insidiously and can be hard to detect. Salmonella is an uncommon cause of abscess formation and the subtype of bovismorbificans, arising from geckos, only scarcely reported to cause an abscess. We describe a case in line with SCARE Criteria where a retroperitoneal non-seminomatous germ cell tumour presented with a salmonella bovismorbificans abscess and subsequent bacteraemia.A 37 year old male presented unwell with fevers and right flank pain suggestive of pyelonephritis. He had a salmonella bacteraemia on initial blood cultures, subsequently isolated to be salmonella bovismorbificans, and a CT scan demonstrate a large 7.7 cm retroperitoneal mass with surrounding lymphadenopathy.An initial attempt at tissue sampling failed as the lesion was filled with purulent material requiring a pig tail drain to remain in place. He progressed slowly with resolution of fevers and bacteraemia however the lesion did not reduce in size despite adequate antibiotic treatment for two weeks. A repeat core biopsy and aspiration after 19 days revealed ongoing salmonella infection with a yolk sac tumour and seminoma. His AFP markers at this time were elevated at 3330kIU/L.A underlying malignancy should be consider when a retroperitoneal abscess fails to resolve with adequate treatment especially when a organism unknown to cause abscess is isolated.

Department of Paediatric Surgery, Division of Surgery, Women's and Children's Hospital, 72 King William Road, North Adelaide, South Australia 5006, Australia. Electronic address: mark.j.fitzy@gmail.com.

Department of Surgery and Critical Care, Royal Darwin Hospital, 105 Rocklands Drive, Tiwi, Northern Territory 0810, Australia.

Int J Surg Case Rep . 2024 Oct 23:125:110502. doi: 10.1016/j.ijscr.2024.110502. Online ahead of print.

2210-2612

https://pubmed.ncbi.nlm.nih.gov/39461139/?otool=iaurydwlib

https://hdl.handle.net/10137/13762

Abscess

Bovismorbificans

Retroperitoneal

Salmonella

Testicular tumours

Salmonella bovismorbificans abscess masking a primary testicular tumour in the retroperitoneum - A case report.

Journal Article

Publication