Salmonella arizonae bacteremia as the presenting manifestation of human immunodeficiency virus infection following rattlesnake meat ingestion

Recurrent nontyphoid salmonella septicemia is one of the opportunistic infections characteristic of AIDS. The increased incidence of severe salmonellosis in immunocompromised patients is due, in part, to defective cellular immunity. The literature contains reports of nine cases of extraintestinal Salmonella arizonae infections in patients ingesting rattlesnake capsules, all of whom had known underlying medical illnesses. We describe a previously healthy Hispanic man who developed S. arizonae bacteremia as his initial manifestation of infection with the human immunodeficiency virus (HIV). The patient ultimately stated that he had consumed rattlesnake meat for medicinal purposes—a relatively common practice among Hispanics. S. arizonae was cultured from the powder of all capsules remaining in his possession. To our knowledge, this represents the first reported case of S. arizonae bacteremia as the presenting manifestation of HIV infection following the ingestion of capsules containing rattlesnake meat.