The snake raiser lung: An unusual cause of Salmonella enterica subspecies arizonae pneumonia

Salmonella enterica subspecies arizonae is a Gram-negative, oxidase-negative bacillus belonging to the Enterobacteriaceae family. This species was first described in reptiles by Cadwell et al in 1939. We report the first isolation of S. enterica sub-species arizonae in bronchial aspirate from a patient presenting with pneumonia. A 73-year-old man was admitted to the intensive care unit (ICU) of Lille Hospital for acute respiratory failure. The patient had a history of chronic obstructive pulmonary disease (COPD) with forced expiratory volume in 1 s of 360 mL, severe asthma, allergic bronchopulmonary aspergillosis, and diabetes. He had been treated with itraconazole, omalizumab, prednisolone, terbutaline, and ipratropium bromure monohydrate for a long time. Our findings suggest that patients presenting with local or sys- temic immunosuppression must be cautious when manipulating or even staying close to snakes. Physicians must be aware of this rare cause of infections, including pneumonia, particularly in such frail patients.