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Princess I, Theckumparampil NPJ, Dorairajan SK. Salmonella Typhi sternoclavicular abscess with osteomyelitis-a rare case report. Indian J Thorac Cardiovasc Surg 2024; 40:250-253. [PMID: 38389760 PMCID: PMC10879046 DOI: 10.1007/s12055-023-01648-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2023] [Revised: 11/03/2023] [Accepted: 11/06/2023] [Indexed: 02/24/2024] Open
Abstract
Salmonella Typhi osteomyelitis is a rare occurrence as compared to enteric fever and diarrhoea which are common manifestations caused by this microorganism. In reported cases of Salmonella osteomyelitis, commonly involved sites are long bones like the femur and humerus. Uncommon reports of Salmonella osteomyelitis from sites such as radius, ulna, tibia and vertebrae have also emerged. Extremely rare incidences of the same have been reported from the clavicle, skull and small bones of hands. Osteomyelitis could be bacterial or non-bacterial, and among bacterial osteomyelitis, Salmonella Typhi is a very rare entity. We present a case of Salmonella osteomyelitis and discuss the importance of microbiological diagnosis of osteomyelitis in diagnosing unusual pathogens from unusual sites. This case report is unique due to its site and difference in clinical presentation. The difference in presentation in an elderly immunocompetent male with no major comorbidities was different from other reported cases. Our patient was successfully managed with surgical debridement followed by a series of vacuum dressings and intravenous antibiotics for 6 weeks.
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Affiliation(s)
- Isabella Princess
- Department of Microbiology, Apollo Speciality Hospitals, Vanagaram, Chennai, 600095 India
| | | | - Suresh Kumar Dorairajan
- Department of Infectious Diseases, Apollo Speciality Hospitals, Vanagaram, Chennai, 600095 India
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2
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Starnes LS, Krehnbrink M, Carroll AR, Brown C. A Pain in the Neck: An Adolescent with Neck Pain. Pediatr Rev 2022; 43:174-177. [PMID: 35229110 PMCID: PMC8996527 DOI: 10.1542/pir.2020-004168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Affiliation(s)
| | | | - Alison R Carroll
- Division of Pediatric Hospital Medicine, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN
| | - Charlotte Brown
- Division of Pediatric Hospital Medicine, Monroe Carell Jr Children's Hospital at Vanderbilt, Nashville, TN
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3
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Willen J, Mayer J, Habeck C, Weiner S. Chronic Salmonella Osteomyelitis in a Healthy, Immunocompetent Man: A Case Report. JBJS Case Connect 2021; 11:01709767-202112000-00079. [PMID: 34937045 DOI: 10.2106/jbjs.cc.21.00356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CASE A 26-year-old healthcare professional presented with knee pain and was found to have Salmonella osteomyelitis of the distal femur. Two operations, including antibiotic bead placement followed by a 6-week course of oral ciprofloxacin, were successful in eradicating the infection. CONCLUSION Salmonella osteomyelitis is a well-known complication of hemoglobinopathies but is unusual in healthy individuals. This case required molecular testing and multiple cultures to obtain a diagnosis. Treatment may require debridement and antibiotics.
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Affiliation(s)
- Jacob Willen
- Department of Orthopaedic Surgery, Summa Health System - Akron City Hospital, Akron, Ohio
| | - Joseph Mayer
- Department of Orthopedic Surgery, Northeast Ohio Medical University, Rootstown, Ohio
| | - Caleb Habeck
- Department of Pediatrics, Akron Children's Hospital, Akron, Ohio
| | - Scott Weiner
- Department of Orthopaedic Surgery, Summa Health System - Akron City Hospital, Akron, Ohio
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4
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Saravu K, Bhat SN, Gupta N. Spondylodiscitis due to Salmonella Typhi: a series of four cases. Oxf Med Case Reports 2021; 2021:omab128. [PMID: 34987856 PMCID: PMC8713587 DOI: 10.1093/omcr/omab128] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 10/01/2021] [Accepted: 11/24/2021] [Indexed: 11/14/2022] Open
Abstract
Salmonella Typhi is very rarely associated with focal bone and joint complications. Classically, they are described in patients with risk factors such as haemoglobinopathies. We report four cases of spondylodiscitis, where the aetiology was found to be Salmonella Typhi. All four cases were treated successfully with variable duration of ceftriaxone followed by cotrimoxazole. We report these cases to highlight the importance of obtaining a microbiological diagnosis and the possibility of a rare infection in endemic settings.
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Affiliation(s)
- Kavitha Saravu
- Department of Infectious Diseases, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Shyamasunder N Bhat
- Department of Orthopaedics, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - Nitin Gupta
- Department of Infectious Diseases, Kasturba Medical College Manipal, Manipal Academy of Higher Education, Manipal, Karnataka, India.,Manipal Center for Infectious Diseases, Prasanna School of Public Health, Manipal Academy of Higher Education, Manipal, Karnataka, India
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5
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Huang ZD, Wang CX, Shi TB, Wu BJ, Chen Y, Li WB, Fang XY, Zhang WM. Salmonella Osteomyelitis in Adults: A Systematic Review. Orthop Surg 2021; 13:1135-1140. [PMID: 33942967 PMCID: PMC8274199 DOI: 10.1111/os.12912] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2020] [Revised: 11/01/2020] [Accepted: 11/29/2020] [Indexed: 12/04/2022] Open
Abstract
The aim of this systematic review was to characterize the clinical features of adults with Salmonella osteomyelitis and summarize diagnosis and treatment methods to provide guidance for clinicians. This systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses (PRISMA) guidelines. We conducted a literature search in the PubMed, EMBASE, and Cochrane Library databases. Article screening and data extraction were performed by two reviewers individually. All the included studies were independently evaluated by two reviewers using the Methodological Index for Non‐Randomized Studies (MINORS) criteria. A total of 67 articles published between 1970 and 2019 were selected, which include 69 patients with an average age of 47.5 years (range, 18–79).The majority of cases (47.76%) occurred in immunocompetent adults without common risk factors. Aspiration and biopsy cultures were all positive in Salmonella osteomyelitis patients who underwent aspiration or biopsy. All infections were monomicrobial, and a total of 12 different serotypes were identified. The three most commonly reported Salmonella serotypes were Salmonella typhi (19 cases), Salmonella typhimurium (12 cases), and Salmonella enteritidis (11 cases). Only 12 of the 67 cases in our data (17.91%) had diarrhea symptoms, and 44 of the 67 cases (65.67%) had fever symptoms. Fifty‐nine of the 67 cases (88.06%) had local inflammatory manifestations, such as erythema, swelling, and tenderness in the affected area. The commonly reported involved sites were the vertebrae, femur, and tibia. Antibiotic therapy alone was utilized in 30 cases, and 24 patients (80.00%) were eventually cured. In total, 75.68% of patients achieved satisfactory results after treatment with surgery and antibiotics. Third‐generation cephalosporins were most commonly utilized, and antibiotic treatment was administered for an average of 11.3 weeks (95% CI, 8.31–14.37 weeks). Salmonella osteomyelitis should be considered in patients without any common risk factors. Aspiration or biopsy can facilitate the identification of pathogens to guide antibiotic choice. Empirical therapy with a third‐generation cephalosporin is recommended until the susceptibility of the strain is determined.
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Affiliation(s)
- Zi-da Huang
- First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Chao-Xin Wang
- First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Teng-Bin Shi
- First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Bai-Jian Wu
- First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Yang Chen
- First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Wen-Bo Li
- First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Xin-Yu Fang
- First Affiliated Hospital of Fujian Medical University, Fuzhou, China
| | - Wen-Ming Zhang
- First Affiliated Hospital of Fujian Medical University, Fuzhou, China
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6
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Neri T, Dehon M, Botelho-Nevers E, Cazorla C, Putnis S, Philippot R, Farizon F, Boyer B. Salmonella infection after anterior cruciate ligament reconstruction: A case report. World J Orthop 2021; 12:246-253. [PMID: 33959488 PMCID: PMC8082509 DOI: 10.5312/wjo.v12.i4.246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/25/2021] [Accepted: 03/29/2021] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Infections after anterior cruciate ligament reconstruction (ACLR) are rare. No cases of Salmonella infection have been described to our knowledge.
CASE SUMMARY We describe a rare case of Salmonella infection in a 23-year-old patient following an ACLR. The patient presented with subacute septic arthritis, 26 d after a hamstring autograft ACLR. The pathogen, Salmonella enterica typhimurium was isolated by bacteriological sampling of the first arthroscopic lavage. Two arthroscopic lavages were required, with intravenous antibiotic therapy for two weeks with cefotaxime and ciprofloxacin, followed by oral antibiotics with amoxicillin and ciprofloxacin for a total duration of three months. This approach treated the infection but two years after the septic arthritis, faced with ongoing knee instability due to graft damage, a revision ACLR with a bone-tendon-bone graft was performed. At the last follow-up, full range of knee motion had been achieved and sports activities resumed.
CONCLUSION Infection after ACLR is rare and requires an early diagnosis and management in order to treat the infection and prevent arthritis-related joint cartilage destruction and damage to the graft.
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Affiliation(s)
- Thomas Neri
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Etienne, Saint-Etienne 42000, France
- EA 7424-Inter-University Laboratory of Human Movement Science, University Lyon-University Jean Monnet Saint Etienne, Saint Etienne 42000, France
| | - Margaux Dehon
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Etienne, Saint-Etienne 42000, France
| | - Elisabeth Botelho-Nevers
- Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne 42000, France
| | - Celine Cazorla
- Infectious Diseases Department, University Hospital of Saint-Etienne, Saint-Etienne 42000, France
| | - Sven Putnis
- Avon Orthopaedic Centre, Southmead Hospital, Bristol, BS10 5NB, United Kingdom
| | - Remi Philippot
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Etienne, Saint-Etienne 42000, France
| | - Frederic Farizon
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Etienne, Saint-Etienne 42000, France
| | - Bertrand Boyer
- Department of Orthopaedic Surgery, University Hospital Centre of Saint-Etienne, Saint-Etienne 42000, France
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Reconstruction of E. coli Osteomyelitis of Costa: A Case Report. PLASTIC AND RECONSTRUCTIVE SURGERY-GLOBAL OPEN 2021; 9:e3413. [PMID: 33680661 PMCID: PMC7929541 DOI: 10.1097/gox.0000000000003413] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 12/10/2020] [Indexed: 11/27/2022]
Abstract
We report a case of E. coli osteomyelitis of the ribs in an immunocompetent 66-year-old man. After radical surgical debridement, bone and soft-tissue defects were covered with a rectus abdominis muscle flap. The postoperative course was uneventful, and there was no recurrence of chest symptoms. Among the various types of osteomyelitis, Gram-negative bacteria such as E. coli osteomyelitis is a relatively rare disease. Osteomyelitis is known to supervene in trauma or postoperative infection and to frequently begin with cellulitis, vascular access, endocarditis, or urinary tract infection, which spreads through the blood to the bone. To add to the difficulty of making a correct diagnosis, the early symptoms of osteomyelitis are often non-specific. We should never forget osteomyelitis in the differential diagnosis of these antecedent infections.
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Nontyphoidal Salmonella Osteomyelitis in an Immunocompetent Adult Without Preceding Symptoms. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2021. [DOI: 10.1097/ipc.0000000000000922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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9
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V V, Subramanian B, Muthulingam M. A Case Report of Salmonella Typhi Osteomyelitis With Pathological Fracture in an Immunocompetent Adult. Cureus 2020; 12:e12211. [PMID: 33489618 PMCID: PMC7815291 DOI: 10.7759/cureus.12211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
Salmonella osteomyelitis is usually seen in patients with hemoglobinopathies and immunodeficient individuals. However, it is a rare clinical entity in an immunocompetent person with very few cases reported in clinical literature usually caused by non-typhoid Salmonella. Here, we report a case of S. typhi osteomyelitis of the right tibia in a 40-year-old immunocompetent lady. She developed a pathological fracture of the right tibia during the course of her treatment. It was then managed successfully by debridement and external fixation using a rail fixator. Salmonella osteomyelitis does not present with unique clinical or radiological signs. High index of suspicion with appropriate testing will help in determining the causative agent correctly and thus aid in its successful management.
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Affiliation(s)
- Venkataram V
- Orthopedics and Traumatology, Mahatma Gandhi Medical College and Research Institute, Puducherry, IND
| | - Bhooma Subramanian
- Orthopedics, Mahatma Gandhi Medical College and Research Institute, Puducherry, IND
| | - Manoharan Muthulingam
- Orthopedic Surgery, Mahatma Gandhi Medical College and Research Institute, Puducherry, IND
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10
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Sakamoto A, Chigusa Y, Noguchi T, Matsuda S. Salmonella osteomyelitis of the distal radius in a healthy pregnant woman. J Bone Jt Infect 2020; 6:1-5. [PMID: 32983841 PMCID: PMC7517663 DOI: 10.5194/jbji-6-1-2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Accepted: 07/05/2020] [Indexed: 11/11/2022] Open
Abstract
Although characteristic,
Salmonella is a rare cause of
osteomyelitis, especially in healthy individuals. A
25-year old primigravida at 29 weeks' gestation noticed pain and swelling in her right wrist. Her leukocyte count was normal, but her C-reactive protein
level was slightly elevated, at 1.1 mg dL-1 (normal range, <0.2 mg dL-1). Plain radiography showed an osteolytic lesion in the distal radius,
and magnetic resonance imaging (MRI) showed an extraosseous fluid collection
with bone edema in addition to the osseous lesion.
After a needle biopsy was performed, the skin overlying the lesion became
ulcerated at the site of the needle tract. We drained whitish pus from the
site; both this pus and the original biopsy specimen grew
Salmonella on culture. We diagnosed
Salmonella osteomyelitis and began intravenous
antibiotic therapy, avoiding oral quinolones to prevent fetotoxicity. Her
symptoms resolved, as did the bone edema and fluid collection. Ossification
occurred at the site of osteolysis, with localized abnormal signal intensity
persisting on MRI. This rare case of Salmonella osteomyelitis was treated without
surgery; the patient's pregnancy influenced the treatment course.
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Affiliation(s)
- Akio Sakamoto
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Yoshitsugu Chigusa
- Department of Gynecology and Obstetrics, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Takashi Noguchi
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Shuichi Matsuda
- Department of Orthopaedic Surgery, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
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11
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Lucia MH, Manuel PSJ, Angel LIJ, Gabriel GS, Javier GC. Lumbar Salmonella osteomyelitis with psoas muscle abscess in a patient with prostate cancer. IDCases 2020; 21:e00887. [PMID: 32642435 PMCID: PMC7334485 DOI: 10.1016/j.idcr.2020.e00887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 06/25/2020] [Accepted: 06/25/2020] [Indexed: 11/04/2022] Open
Abstract
Salmonella osteomyelitis is a rare clinical entity more commonly described in grounds of sickle cell disease however some cases has been described in patients without this pathology but an immunocompromised state, which also predisposes to the development of a psoas abscess. We present the case of a 77-year-old man with persistent hip pain and recent diagnosis of prostate cancer who developed lumbar osteomyelitis and a secondary psoas abscess due contiguous spread. Treatment included a third-generation cephalosporine and fluoroquinolone without surgical drainage with a good prognosis overall.
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12
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Rohilla R, Bhatia M, Gupta P, Singh A, Shankar R, Omar BJ. Salmonella osteomyelitis: A rare extraintestinal manifestation of an endemic pathogen. J Lab Physicians 2019; 11:164-170. [PMID: 31160858 PMCID: PMC6543939 DOI: 10.4103/jlp.jlp_165_18] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Accepted: 02/13/2019] [Indexed: 11/04/2022] Open
Abstract
Salmonella enterica serovar Typhi and Paratyphi usually cause enteric fever in humans characterized by fever and gastrointestinal symptoms such as diarrhea. Bacteremia is a constant feature of enteric fever, and occasionally, dissemination of bacilli throughout the body results in the establishment of one or more localized foci of persisting infection. This happens especially in patients with preexisting conditions such as hemoglobinopathies, previous joint trauma, surgery, connective tissue diseases, lymphoma, diabetes, alcoholism, immunosuppressive state, and extremes of ages. Rarely, these extraintestinal Salmonella infection cases have also been reported in immunocompetent individuals without any obvious predisposing factors. Salmonella osteomyelitis, a rare sequelae of typhoid, may occur as a result of hematogenous seeding of the bone or joints due to a bacteremic episode. It may also spread from nearby areas of infection or penetrating trauma. Timely diagnosis and treatment of this condition are necessary because if left untreated, it can lead to permanent functional deficits later on. We hereby present a case series with brief review of literature on Salmonella osteomyelitis in immunocompetent patients without any known predisposing conditions over a period of 1 year (2017-2018) from a Tertiary Care Teaching Hospital in Uttarakhand, India.
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Affiliation(s)
- Ranjana Rohilla
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Mohit Bhatia
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Pratima Gupta
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Arpana Singh
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Shankar
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Balram Ji Omar
- Department of Microbiology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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13
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Cheng W, Lian K, Luo D, Lin D, Feng W, Xian H, Li T. Salmonella potsdam causing lumbar vertebral osteomyelitis: A case report. Medicine (Baltimore) 2018; 97:e0682. [PMID: 29718896 PMCID: PMC6392897 DOI: 10.1097/md.0000000000010682] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 04/17/2018] [Indexed: 11/25/2022] Open
Abstract
RATIONALE Salmonella osteomyelitis is an uncommon complication of salmonella infection, especially the salmonella vertebral osteomyelitis (SVO). PATIENT CONCERNS We reported a case of a 29-year-old female who presented with serious lower back pain and severe limitation of motion for 50 days with no obvious inducements. She once had a fever up to 39.5°C. Physical examination only revealed limited motion of lower back without neurological complications. The laboratory results revealed no specificity. MRI of the lumbar spine revealed a spondylodiscitis at L4-L5. She underwent anterior lateral approach debridement and percutaneous posterior instrumentation. DIAGNOSES Tissue and abscess culture grew showed Salmonella Potsdam infection. INTERVENTIONS With susceptibility testing guidance, the patient was treated with intravenous levofloxacin and ceftazidime for a period of 3 weeks and another 3-week oral antibiotics therapy. OUTCOMES The patient recovered well with no neurological deficits during the follow-up time. LESSONS SVO is really rare and it alerts us the importance to consider uncommon pathogens in the differential diagnosis in which the etiological evidences are crucial of healthy individuals.
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Anegundi R, Banerjee B, Mukhopadhyay C, Nishanth A, Shyamasunder Bhat N. Finding Salmonella in unusual sites: look before you leap. A case series. Trop Doct 2017; 48:127-131. [PMID: 29192547 DOI: 10.1177/0049475517743675] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Renuka Anegundi
- 1 Assistant Professor, Department of Microbiology, 29224 Kasturba Medical College , Manipal, Karnataka, India
| | - Barnini Banerjee
- 2 Associate Professor, Department of Microbiology, 29224 Kasturba Medical College , Manipal, Karnataka, India
| | - Chiranjay Mukhopadhyay
- 3 Professor, Department of Orthopaedics, 29224 Kasturba Medical College , Manipal, Karnataka, India
| | - A Nishanth
- 4 Assistant Professor, Department of Orthopaedics, 29224 Kasturba Medical College , Manipal, Karnataka, India
| | - N Shyamasunder Bhat
- 3 Professor, Department of Orthopaedics, 29224 Kasturba Medical College , Manipal, Karnataka, India
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15
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Martínez-Serrano M, Arranz-Solana C, Martínez-Alfaro E, Crespo-Sánchez MD. Right knee pain, swelling and fever in a young immunocompetent male. Enferm Infecc Microbiol Clin 2014; 32:396-7. [PMID: 24447920 DOI: 10.1016/j.eimc.2013.11.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2013] [Accepted: 11/13/2013] [Indexed: 10/25/2022]
Affiliation(s)
- Maria Martínez-Serrano
- Servicio de Microbiología, Complejo Hospitalario Universitario de Albacete, Albacete, Spain.
| | - César Arranz-Solana
- Servicio de Medicina Interna, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
| | - Elisa Martínez-Alfaro
- Unidad de Enfermedades Infecciosas, Servicio de Medicina Interna, Complejo Hospitalario Universitario de Albacete, Albacete, Spain
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16
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Salem KH. Salmonella osteomyelitis: A rare differential diagnosis in osteolytic lesions around the knee. J Infect Public Health 2013; 7:66-9. [PMID: 24011620 DOI: 10.1016/j.jiph.2013.07.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2013] [Accepted: 07/14/2013] [Indexed: 11/17/2022] Open
Abstract
Salmonella osteomyelitis in immunocompetent adults is uncommon. It usually has a diaphyseal location or present as spondylitis. Metaphyseal affection is extremely rare. A 51-year-old male presented with refractory knee pain. Plain X-rays showed a rounded osteolytic lesion in the proximal tibia without marginal sclerosis. A minimal C-reactive protein elevation and a normal leucocytic count were present. Further imaging raised suspicion of malignancy so that a biopsy was done. After fenestering the lesion, 15-ml turbid fluid was evacuated. Microbiological examination showed Salmonella enteritidis. Repeated debridements were done and antibiotic therapy with ciprofloxacin was initiated. The cavity was then filled with synthetic bone graft leading to progressive healing. Although rare, Salmonella bone infection usually lacks the typical periosteal reaction and the laboratory evidence of infection of pyogenic osteomyelitis. It should therefore be considered in the differential diagnosis of osteolytic neoplastic lesions.
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17
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Mathuram A, Rijn RV, Varghese GM. Salmonella typhi rib osteomyelitis with abscess mimicking a 'cold abscess'. J Glob Infect Dis 2013; 5:80-1. [PMID: 23853436 PMCID: PMC3703215 DOI: 10.4103/0974-777x.112271] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Salmonella enterica serovar typhi (Salmonella typhi) causing typhoid fever is common in many parts of the world particularly in developing countries. Extra-intestinal manifestations such as osteomyelitis are rare in immunocompetent individuals. We report a case of Salmonella typhi osteomyelitis of a rib with overlying abscess mimicking a ‘cold abscess’, treatment outcomes and discuss relevant literature.
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Affiliation(s)
- Alice Mathuram
- Department of Medicine and Infectious Diseases, Christian Medical College, Vellore, Tamil Nadu, India
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18
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Tickell KD, Banim R, Kustos I. Salmonella sternoclavicular osteomyelitis in a patient with Crohn's disease. BMJ Case Rep 2013; 2013:bcr-2012-007809. [PMID: 23345484 DOI: 10.1136/bcr-2012-007809] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We describe a 73-year-old man with Crohn's disease and previous sternotomies, who developed Salmonella sternoclavicular osteomyelitis subsequent to a Salmonella enteritidis sepsis and closed fracture of his clavicle. We include evidence from several cases related to sternoclavicular osteomyelitis, and Salmonella osteomyelitis. We continue by summarising the aetologies of these diseases, and risk factors that predispose to them.
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Kaistha N, Gupta V, Sidhu S, Chander J. Salmonella-salmonellosis-rare presentations of a common pathogen. ASIAN PAC J TROP MED 2011; 4:417-20. [PMID: 21771690 DOI: 10.1016/s1995-7645(11)60117-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2011] [Revised: 04/17/2011] [Accepted: 05/15/2011] [Indexed: 10/18/2022] Open
Abstract
Salmonella are most commonly associated with gastroenteritis and enteric fever in humans. Occasionally, dissemination of bacilli throughout the body results in establishment of localized foci of persistent infection especially in patients with debilitating diseases and immunosuppressive states. Infection at various aberrant sites due to Salmonella has been reported relatively seldom. It has perfected the art of intracellular survival in niches from where they can cause myriad of effects. Six cases with Salmonella infection at unusual sites without any preexisting or underlying disease diagnosed over a period of two years are presented here. Salmonella etiology was not suspected in these patients and the diagnosis was made microbiologically only after culture isolation.
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Affiliation(s)
- Neelam Kaistha
- Department of Microbiology, Government Medical College & Hospital-32, Chandigarh, India
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Angela HWH, Tong CS, Lam CW, Hung YC, Cheung WW. Salmonella Osteomyelitis of the Pelvis in Healthy Adults: A Case Report. JOURNAL OF ORTHOPAEDICS, TRAUMA AND REHABILITATION 2011. [DOI: 10.1016/j.jotr.2010.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
We report a case of a healthy 32-year-old patient suffering from Salmonella osteomyelitis of the pelvis. He was treated successfully with surgical debridement and third-generation cephalosporin.
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Affiliation(s)
| | - Choi Siu Tong
- Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong
| | - Chan Wai Lam
- Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong
| | - Yen Chi Hung
- Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong
| | - Wong Wing Cheung
- Department of Orthopaedics and Traumatology, Kwong Wah Hospital, Hong Kong
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Gould ES, Gilet AG, Vigorita VJ. Granulomatous salmonella osteomyelitis associated with anti-tumor necrosis factor therapy in a non-sickle cell patient: a case report. Skeletal Radiol 2010; 39:821-5. [PMID: 20596812 DOI: 10.1007/s00256-010-0894-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2009] [Revised: 01/01/2010] [Accepted: 01/27/2010] [Indexed: 02/02/2023]
Abstract
Salmonella osteomyelitis is seen most commonly in patients with sickle cell disease and in those with compromised immune systems. We report on the clinical, histological and imaging findings of salmonella osteomyelitis with intraosseous abscess formation occurring in a non-sickle cell patient receiving anti-tumor necrosis factor (TNF) alpha therapy.
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Affiliation(s)
- Elaine S Gould
- Department of Radiology, State University of New York at Stony Brook, Stony Brook, NY 11794-8460, USA.
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Bhooshan P, Shivaprakasha S, Dinesh KR, Kiran M, Karim PMS. Chronic subdural empyema and cranial vault osteomyelitis due to Salmonella paratyphi A. Indian J Med Microbiol 2010; 28:60-2. [DOI: 10.4103/0255-0857.58733] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Abstract
Salmonella species are rare bacterial isolates in osteomyelitis. This article describes a case of an otherwise healthy, active duty male military member with an insidious onset of right knee pain during a deployment to Kuwait. His work-up revealed an infectious process in the distal femur. Operative treatment and intravenous antibiotics resolved the infection. Intraoperative cultures revealed the rare isolate Salmonella enterica serotype C2 (Newport). Postoperative medical management revealed new-onset diabetes mellitus, possibly making this otherwise healthy host susceptible to this rare infection. Salmonella are gram-negative bacteria. Infection with nontyphoidal Salmonella species most commonly manifests as intestinal illness. Although it may be difficult for clinicians to accurately predict this rare entity as the causative organism in osteomyelitis, they may be aided by a history of travel to endemic regions or exposure to animal carriers. Comorbidities that seem to increase susceptibility include diabetes mellitus, human immunodeficiency virus, hemoglobinopathies, and immunosuppression. Blood cultures are reported to be frequently positive in cases of Salmonella osteomyelitis. Identification of Salmonella species from intraoperative cultures should prompt consultation with the infectious disease department for culture-specific antibiotic tailoring. Many common antibiotic agents active against gram-negative organisms seem efficacious. As in this case, following the basic tenets of osteomyelitis management should lead to an acceptable outcome.
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Affiliation(s)
- Joseph S Gondusky
- Department of Orthopedic Surgery, Naval Medical Center San Diego, 34800 Bob Wilson Drive, San Diego, CA 92134-1112, USA
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Salmonella Gaminara Osteomyelitis and Septic Arthritis in an Infant With Exposure to Bearded Dragon. INFECTIOUS DISEASES IN CLINICAL PRACTICE 2007. [DOI: 10.1097/ipc.0b013e3180325a6d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Huang DB, DuPont HL. Problem pathogens: extra-intestinal complications of Salmonella enterica serotype Typhi infection. THE LANCET. INFECTIOUS DISEASES 2005; 5:341-8. [PMID: 15919620 DOI: 10.1016/s1473-3099(05)70138-9] [Citation(s) in RCA: 83] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Typhoid fever, caused by Salmonella enterica seroptype Typhi (S typhi), has an estimated worldwide prevalence of 12-33 million cases. The pathogenesis of this disease depends on the ingested inoculum size of S typhi, the virulence of the strain, the host's immune response and previous exposure, and local protective factors. Numerous extra-intestinal complications can occur with S typhi infection, including the involvement of the central nervous system (3-35%), cardiovascular system (1-5%), pulmonary system (1-86%), bone and joints (< or =1%), hepatobiliary system (1-26%), genitourinary system (<1%), and others. Due to an increase in multidrug-resistant S typhi, fluoroquinolones and third-generation cephalosporins have been increasingly used for typhoid fever and its complications. We describe the epidemiology, clinical manifestations, pathogenesis, and treatment of extra-intestinal S typhi infections.
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Affiliation(s)
- David B Huang
- Center for Infectious Diseases, Baylor College of Medicine, Houston, Texas 77030, USA.
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