Recurrent Salmonella arizona infection after treatment for metastatic carcinoma.

Serious Salmonella arizona infection may be acquired through the ingestion of rattlesnake meat used as a folk medicine remedy. We report a patient with metastatic carcinoma and a remote history of rattlesnake meat ingestion who developed recurrent S. arizona bacteremia and reactivation of tuberculosis after receiving corticosteroid and radiation therapy. Physicians should be aware of the potential for rattlesnake-associated S. arizona infection to occur as either the presenting manifestation or as a complication in immunosuppressed patients who may take folk remedies, especially Hispanics who live along the United States-Mexico border.

[Desiccated rattlesnake capsules: a potential source of gram-negative bacterial infection]. / Cápsulas de víbora desecada: una fuente potencial de infección por bacterias gram negativas.

The ingestion of rattlesnake powder capsules is frequent in Mexico in view of their alleged curative properties in various diseases, among them different malignancies. Based on previous reports showing both bacteremia and septicemia in patients with malignant diseases ingesting such capsules, we conducted a study to evaluate the presence of microorganisms in 16 different preparations of rattlesnake powder capsules, obtained in six different cities of our country. We found that all the samples were significantly contaminated with gram-negative coliform bacteria: Escherichia coli, Klebsiella pneumoniae, Enterobacter agglomerans, E. cloacae, Salmonella arizona and Salmonella of groups B, E4 and G. Eighty one percent of the capsules were contaminated with Salmonella sp. The most frequent was S. arizona with a natural reservoir in snakes. Contamination was probably derived from both the flesh of the snake and fecal contamination during the domestic preparation of the powder to produce the capsules. These data, together with those previously published regarding bacteremia and septicemia derived from the ingestion of the capsules, suggests that there is danger in their use.

Salmonella arizona arthritis and septicemia associated with rattlesnake ingestion by patients with connective tissue diseases. A dangerous complication of folk medicine.

Snakes constitute the main reservoir of Salmonella arizona, which are opportunistic pathogens in patients with serious underlying diseases. The 2 may meet when such patients ingest uncooked snake flesh, most often as a folk remedy for arthritis or other conditions. We have seen 11 patients in whom Salmonella arizona infection was documented. Six had systemic lupus erythematosus and another had dermatomyositis and are described in detail. All 7 had received prednisone, which was combined with azathioprine in 3. Five developed septic arthritis, including the site of a hip prosthesis in one patient. A history of dessicated rattlesnake ingestion as a "natural" remedy in either capsule or powder form was obtained in all but one of the 7 patients. Patients often think that if natural or folk remedies are not helpful they also are not harmful and, therefore, safe and worth trying. We disprove that belief and call attention to the perils of one such remedy: dessicated rattlesnake, particularly when ingested by patients with connective tissue diseases who may be immunocompromised.

Salmonella arizona infections in Latinos associated with rattlesnake folk medicine.

In 1987 two Los Angeles County (California) hospitals reported four Latino patients with serious Salmonella arizona (Salmonella subgroup 3) infections who gave a medical history of taking rattlesnake capsules prior to illness. Capsules supplied by the patients or household members grew Salmonella arizona. We reviewed surveillance data for this Salmonella species and conducted a case-control study to determine the magnitude of this public health problem. Eighteen (82 percent) of the 22 Latino cases in 1986 and 1987 who were questioned reported ingesting snake capsules compared to two (8 percent) of 24 matched Latino controls with non-subgroup 3 salmonellosis or shigellosis (matched pair odds ratio = 18.0, CI = 4.2, 76.3). An average of 18 cases per year of Salmonella arizona were reported in the county between 1980 and 1987. In this investigation the majority of S. arizona cases reporting snake capsule ingestion had underlying illnesses such as acquired immunodeficiency syndrome (AIDS), diabetes, arthritis, cancer. The capsules were obtained primarily from Tijuana, Mexico and from Los Angeles, California pharmacies in Latino neighborhoods. Despite publicity and attempts to remove the capsules from sale in California, Salmonella arizona cases associated with snake-capsule ingestion continue to occur.

Isolation of salmonellae from dried rattlesnake preparations.

Salmonella arizonae and other Salmonella serovars were isolated from four different rattlesnake preparations which were used for self-treatment of various diseases. A case of disseminated S. arizonae infection is reported in a patient who had acquired immunodeficiency syndrome and ingested dried rattlesnake.