Vertebral discitis caused by serovar Montevideo infection.
IDCases
Salmonellosis is a common cause of foodborne illness worldwide, manifesting as non-invasive non-typhoidal salmonellosis, invasive non-typhoidal salmonellosis, and typhoid fever. It also rarely presents as osteomyelitis in children with hemoglobinopathies and immunocompromised adults and even rarer osteomyelitis in an immunocompetent host without significant risk factors. Our case is of a 38-year-old immunocompetent male without significant risk factors presented with biopsy proven vertebral discitis due to exposure to contaminated and undercooked poultry. It illustrates the importance of thorough and complete history taking even in immunocompetent patients and early recognition with prompt targeted treatment of osteomyelitis/discitis to prevent unfavorable outcomes.
10.1016/j.idcr.2023.e01882
[Spontaneous cervical spondylodiscitis caused by Salmonella typhi in an immunocompetent patient].
Falavigna Asdrubal,Ferraz Fernando Antonio Patriani
Arquivos de neuro-psiquiatria
We report a case of spontaneous cervical spondylodiscitis caused by Salmonella typhi. A 52-year-old man presented in the neurosurgical service with complaints of pain in the cervical and scapular region. Cervical inflammatory disease was suggested by bone scintigraphy and magnetic resonance imaging. The diagnosis of Salmonella typhi spondylodiscitis was established by blood culture and culture of needle biopsy specimen taken from the C5 vertebra. The agglutinin titers for Salmonella were elevated. Intravenous ciprofloxacin therapy and external immobilization with a halo vest were instituted. A review of literature was performed evaluating the clinical, diagnostic and therapeutic aspects of this unusual pathology.
Spondylodiscitis due to Sallmonela in an immunocompetent patient.
Shkurti-Leka Klodiana,Kraja Dhimiter,Leka Nikollaq,Vreto Gjergji,Melyshi Kastriot,Kasmi Genti
Medicinski arhiv
Salmonella is a gram-negative bacillus that penetrates in human from contaminated food or water. Sallmonela spondylodiscitis is a rare condition occur secondary to hematogenous spread after bacteremia episode. We presented a successful treatment with Levofloxacin in a 26 years old immunocompetent male with a septic form of sallmonelosis complicated with lumbar spondylodiscitis without surgery. He was treated with intravenous Levofloxacin for three weeks and was discharged from the hospital with oral Levofloxacin for more than two months. Clinical and laboratory evaluation two months after oral treatment resulted normal.
10.5455/medarh.2011.65.252-253
Salmonella diskitis in a 2-year old immunocompetent child.
Barkai Galia,Leibovitz Eugene,Smolnikov Alexander,Tal Asher,Cohen Eugen
Scandinavian journal of infectious diseases
Spine infections are uncommon in paediatrics and are generally caused by Staphylococcus aureus. Salmonella spp. are a rare cause of spine infections, usually affecting children with sickle-cell anaemia. We present a case of group C1 Salmonella diskitis in a previously healty 2-y-old child, and review the relevant literature.
10.1080/00365540410020767
[Spondylodiscitis due to Salmonella enteritica serotype Typhi].
Zebouh M,Loïez C,Marceau L,Vieillard M H,Izard D,Courcol R J
Annales de biologie clinique
We reported a case of lombar spondylodiscitis caused by Salmonella enteritica serotype Typhi in an immunocompetent patient. Salmonella is a rare causative agent of spondylodiscitis. Early bacteriological diagnosis is essential to avoid longterm sequelae.
Salmonella Typhi Vertebral Osteomyelitis and Epidural Abscess.
Khoo Hau Wei,Chua Ying Ying,Chen John L T
Case reports in orthopedics
Salmonella vertebral osteomyelitis is an uncommon complication of Salmonella infection. We report a case of a 57-year-old transgender male who presented with lower back pain for a period of one month following a fall. Physical examination only revealed tenderness over the lower back with no neurological deficits. MRI of the thoracic and lumbar spine revealed a spondylodiscitis at T10-T11 and T12-L1 and right posterior epidural collection at the T9-T10 level. He underwent decompression laminectomy with segmental instrumentation and fusion of T8 to L3 vertebrae. Intraoperatively, he was found to have acute-on-chronic osteomyelitis in T10 and T11, epidural abscess, and discitis in T12-L1. Tissue and wound culture grew Salmonella Typhi and with antibiotics susceptibility guidance he was treated with intravenous ceftriaxone for a period of six weeks. He recovered well with no neurological deficits.
10.1155/2016/6798157
Salmonella vertebral osteomyelitis and epidural abscess in a child with sickle cell anemia.
Gardner R V
Pediatric emergency care
A case of Salmonella vertebral osteomyelitis with epidural abscess in a child with sickle cell anemia is presented. Spinal osteomyelitis is a rare event in children. Although osteomyelitis in sickle cell anemia may occur in any bone, it has most often been documented as beginning in the medullary cavity of the long and tubular bones. This is in contrast to the clinical presentation of osteomyelitis in the normal individual, who is likely to have infection beginning in and restricted to the metaphyseal regions of bones. Nonspecific or constitutional symptomatology may obscure the diagnosis of vertebral infection with ensuing cord compression. This case stresses the rapidity of development of paralysis or other neurologic complications, as well as the difficulty and emergent nature of the diagnosis of epidural abscess in this situation.
Acute Transverse Myelitis Associated with Salmonella Bacteremia: A Case Report.
Richert Mary E,Hosier Hillary,Weltz Adam S,Wise Eric S,Joshi Manjari,Diaz Jose J
The American journal of case reports
BACKGROUND Acute transverse myelitis (ATM) is an uncommon and often overlooked complication of certain bacterial and viral infections that can have a rapid onset and result in severe neurological deficits. CASE REPORT This case report describes a previously healthy 28-year-old woman who presented to the trauma center after developing acute paralysis and paresthesias of all four extremities within the span of hours. The initial presumptive diagnosis was spinal cord contusion due to a fall versus an unknown mechanism of trauma, but eventual laboratory studies revealed Salmonella bacteremia, indicating a probable diagnosis of parainfectious ATM. CONCLUSIONS This case illustrates the importance of considering the diagnosis of parainfectious ATM in patients presenting with acute paralysis with incomplete or unobtainable medical histories.
10.12659/ajcr.900730
Salmonella osteomyelitis with epidural abscess. A case report with review of osteomyelitis in children with sickle cell anemia.
Martino A M,Winfield J A
Pediatric neurosurgery
Neurologic complications of sickle cell anemia are most commonly ischemic strokes secondary to sludging in cerebral arterioles. We, therefore, report a case of progressive paraparesis in a child with sickle cell anemia which was initially thought to be secondary to a spinal cord ischemic event. Further diagnostics demonstrated that the neurologic deficits were secondary to salmonella osteomyelitis and an epidural abscess, compressing the upper thoracic spinal cord at the T6 level. The diagnostic and radiological features which help to distinguish between bone infarct and osteomyelitis, both responsible for bone pain in sickle cell patients, are also presented. In particular, Tc-sulfur colloid bone marrow imaging is the most helpful test for distinguishing between these similarly presenting clinical entities, as early as 48 h after bone pain develops.
10.1159/000120552
Spinal Abscess Caused by Salmonella Bacteremia in a Patient with Primary Myelofibrosis.
Fareed Shehab,Nashwan Abdulqadir J,Abu Jarir Sulieman,Husain Ahmed,Suliman Dina Sameh,Ibrahim Friyal,Moustafa Abbas,Akhter Muhammad S,Yassin Mohamed A
The American journal of case reports
BACKGROUND In Primary Myelofibrosis (PMF; a clonal disorder arising from the neoplastic transformation of early hematopoietic stem cells) patients, spinal cord compression (SCC) is a common complication or even a presentation symptom due to extramedullary hematopoiesis (EMH). However, a case of SCC caused by a spinal abscess is unusual. To the best of our knowledge, this is the first case report of this rare condition. CASE REPORT We are reporting the case of a 50-year-old male with primary myelofibrosis and long-standing splenomegaly with back pain as a presenting symptom who was found to have spinal cord compression. An MRI was performed, as EMH was suspected. The blood cultures revealed an infection with Salmonella, so the patient was placed on ceftriaxone, with no response. The patient demonstrated substantial clinical improvement after 2 weeks of neurosurgical intervention and pain management. CONCLUSIONS In PMF patients, back pain with fever or mild neurological symptoms needs to be investigated urgently because of the high risk of irreversible spinal cord damage leading to partial or complete loss of functional independence and shortened survival. The compression could be related to EMH or infections due to an immunodeficiency.
10.12659/ajcr.903482
Meningoencephalomyelitis in a foal due to Salmonella agona infection.
Patterson-Kane J C,Bain F T,Donahue J M,Harrison L R
New Zealand veterinary journal
CASE HISTORY:A neonatal Thoroughbred foal was presented with rib fractures and left forelimb lameness secondary to dystocia. CLINICAL FINDINGS:The foal developed a head tilt, seizures and watery diarrhoea during hospitalisation and died at 7 days of age. Histological examination of the brain and spinal cord revealed a suppurative meningoencephalomyelitis with vasculitis, and numerous intralesional, gram-negative bacilli. Similar microscopic lesions were noted in the lungs, renal medullary interstitium, and umbilicus. Bacilli in the brain, spinal cord and umbilicus were identified immunohistochemically as Salmonella group B. Salmonella agona was isolated in pure culture from the brain, lung, liver, kidney, and intestine. CONCLUSION:This is the first report of meningoencephalomyelitis and septicaemia due to Salmonella infection in an equine neonate.
10.1080/00480169.2001.36224
Typhoid spondylodiscitis: the first reported case in Southeast Asia and review of the literature.
Suwanpimolkul Gompol,Nilgate Sumanee,Suankratay Chusana
Journal of the Medical Association of Thailand = Chotmaihet thangphaet
We describe the first case of typhoid spondylodiscitis in Southeast Asia, and the literature were also reviewed. A 57-year-old diabetic Thai man who presented with a one-month course of progressive low back pain associated with paraparesis and bowel-bladder dysfunction. Examination revealed local tenderness over T12 area, spastic paraparesis, impaired pinprick sensation up to T12 level, and loose anal sphincter tone. Magnetic resonance imaging showed spondylodiscitis of T11 and T12 and epidural abscess causing spinal cord compression. T11 and T12 laminectomy, T11/12 discectomy, and debridement of epidural abscess were performed, and the cultures of the pus grew Salmonella Typhi. He was treated with intravenous ciprofloxacin for three weeks and was discharged from the hospital with oral ciprofloxacin and trimethoprim-sulfamethoxazole for another five months of treatment. The patient was doing well when last seen two months after discontinuation of antimicrobial treatment. In addition, a total of ten cases of typhoid spondylitis/spondylodiscitis were reviewed.
Bug on the back: vertebral osteomyelitis secondary to fluoroquinolone resistant Salmonella typhi in an immunocompetent patient.
BMJ case reports
Although Salmonella osteomyelitis is commonly seen in immunocompromised patients, it may occasionally affect an immunocompetent host. Symptoms are usually non-specific, such as fever, abdominal or back pain; hence it should be considered in the differential diagnosis of patients with a history of travel to endemic regions. Fluoroquinolone resistance is rising and non-responsive patients should be treated with ampicillin, trimethoprim-sulfamethoxazole and ceftriaxone. We present a case of acute T8-T11 osteomyelitis with cord compression caused by a fluoroquinolone resistant strain of Salmonella typhi.
10.1136/bcr-2015-212503
Typhoid spondylodiscitis mimicking tuberculosis in a teenage girl.
Banerjee Barnini,Madiyal Mridula,Madhava Pai K,Agarwal Manali,Mukhopadhyay Chiranjay
Journal of infection and public health
Salmonella Typhi cause a broad spectrum of human illnesses like gastroenteritis, typhoid fever, and bacteremia. It has also been recognized as a causative organism of osteomyelitis for more than a century but the incidence appears to be uncommon. Microbiological workup plays important role in the diagnosis of Typhoid spondylodiscitis as most of the time it mimics tuberculosis and misguide the clinician, especially in the developing world. Here, we reported an uncommon case of lumbar spondylodiscitis by Salmonella Typhi in an immunocompetent teenager, with the help of clinical, microbiological and radiological evidence. The case was managed conservatively after posterior spinal stabilization.
10.1016/j.jiph.2017.04.004
[Cervical lymphadenitis caused by no typhoid Salmonella in a diabetic patient].
Velásquez M Adelaida,Ortiz Juliana,Atehortúa Santiago,Agudelo Carlos A
Revista chilena de infectologia : organo oficial de la Sociedad Chilena de Infectologia
No Typhoid Salmonella infection is one of the most common and widely spread foodborne diseases worldwide. Although most cases are limited to the gastrointestinal tract, extraintestinal involvement is not uncommon. However, adenitis as an isolated manifestation, is an unusual form of the disease. We report a case of Salmonella no Typhoid cervical lymphadenitis in a 67-year-old female with a recent diagnosis of diabetes mellitus, who was treated with surgery and ciprofloxacin.
10.4067/S0716-10182017000600610
Invasive Salmonella Enteritidis infection complicated by bacterial meningitis and vertebral osteomyelitis shortly after influenza A infection in an immunocompetent young adult.
Ikejiri Kaoru,Suzuki Kei,Ito Asami,Yasuda Kazunari,Shindo Akihiro,Ishikura Ken,Imai Hiroshi
Journal of infection and chemotherapy : official journal of the Japan Society of Chemotherapy
Non-typhoidal Salmonella usually manifests as a self-limited acute gastroenteritis but may also cause severe invasive infections almost exclusively among children or immunosuppressed patients. A previously healthy 22-year-old man developed high fever with coma, multiple organ failure and shock. He had visited another hospital complaining of fever 2 days previously and was diagnosed with a common cold. No obvious site of infection was identified by radiology and a rapid test for influenza A virus was positive, indicating possible influenza-associated encephalopathy. However, blood as well as CSF culture yielded Salmonella enterica serotype Enteritidis. Therefore, the patient was considered to be suffering from bacterial meningitis with septic shock concomitant with influenza infection. Antiviral drugs and therapy for septic shock were initiated. He stabilized relatively quickly and his mental status dramatically improved. The patient denied preceding gastrointestinal symptoms, but mentioned that he received positive fecal Salmonella species culture results without medical intervention about 3 months previously. His laboratory values showed marked improvement but his elevated inflammatory markers and fever were sustained. On the 17th day of hospitalization, he complained of back pain and MRI showed lumbar vertebral osteomyelitis. This case indicates that (i) invasive Salmonella infection can be developed even in previously healthy adults; (ii) chronic carriage of Salmonella is a predisposing factor to development of invasive infections, and influenza infection may contribute to such "breakthrough infections"; (iii) attention to manifestation of metastatic extra-intestinal foci even after resolution of sepsis is necessary.
10.1016/j.jiac.2019.08.001
Invasive non-typhoidal salmonella infection with multifocal seeding in an immunocompetent host: an emerging disease in the developed world.
Hall Rebecca Louise,Partridge Rebecca,Venkatraman Navin,Wiselka Martin
BMJ case reports
We report an immunocompetent 24-year-old man who presented with a severe, invasive non-typhoidal salmonella (iNTS) infection. He presented with lumbar back pain associated with fever and rigours, which had been preceded by diarrhoea. Blood cultures grew Salmonella enteritidis. An MRI scan of his pelvis and spine showed that he had a small gluteal abscess and sacroiliitis. His condition subsequently deteriorated due to the development of a secondary pneumonia and respiratory failure. He was managed conservatively with 2 weeks of intravenous ceftriaxone, followed by 6 weeks of oral ciprofloxacin. Detailed investigations did not reveal any predisposing factors or evidence of an underlying immunodeficiency. Follow-up showed complete resolution of symptoms with no long-term sequelae.
10.1136/bcr-2012-008230
Thoracic spinal epidural abscess caused by Salmonella typhi.
Abdullah Saad Hamdan,Ata Osama Abu,El-Adwan Nael
Neurologia medico-chirurgica
A 56-year-old man presented with a rare spinal epidural abscess manifesting as attacks of back pain associated with fever, weight loss, generalized weakness and fatigability, and constipation. He had multiple skin pustules in the last 4 months treated with oral amoxicillin. He had suffered diabetes mellitus for the last 5 years and was insulin dependent. Physical examination found slight paraparesis with sensory loss around the nipple and sphincteric urgency, and diabetic retinopathy. Magnetic resonance imaging showed edematous T2, T3, and T4 vertebral bodies, and narrow enhanced T3-4 disk space with a soft tissue enhanced mass mostly anterior to the spinal cord and indenting the cord. T3-4 costotransversectomy was performed to remove the extradural mass and evacuate the intradiscal material. Histological examination of the bone found osteomyelitis, and culture of the soft tissue showed Salmonella typhi sensitive to ceftriaxone and ciprofloxacin. Intravenous ceftriaxone administration was started, and the patient was discharged after 6 days in good condition. The outcome of spinal epidural abscess is devastating unless recognized and treated early. The present case of spinal epidural abscess in the thoracic spine caused by Salmonella typhi infection illustrates the importance of cultures to assess the drug sensitivity of the specific strain detected and adjusting the treatment accordingly.
10.2176/nmc.48.140
Salmonella typhi osteitis can mimic tuberculosis. A report of three cases.
Laloum Etty,Zeller Valérie,Graff Wilfried,Aerts Jean,Chazerain Pascal,Mamoudy Patrick,Ziza Jean Marc,Desplaces Nicole
Joint bone spine
We report three cases of Salmonella typhi osteitis. One patient was an immunocompetent woman with a single focus of osteitis, another had heterozygous sickle cell disease with multifocal osteitis, and the remaining patient had acute discitis. Tuberculosis was considered in all three patients, based on origin from an endemic area (sub-Saharan Africa), a chronic course in the first two patients, and granulomas in a biopsy specimen from one patient.
10.1016/j.jbspin.2003.12.007
Acute transverse myelitis: an unusual complication of typhoid fever.
Mishra Kirtisudha,Kaur Sharandeep,Basu Srikanta,Gulati Praveen,Parakh Ankit
Paediatrics and international child health
Typhoid fever is associated with a wide spectrum of neurological complications. Acute transverse myelitis is a rare complication with only a few reports in adults and none in children. A 15-year-old boy with typhoid fever is reported who developed acute transverse myelitis in the 3rd week of illness. He was treated with antibiotics and corticosteroids and made a complete recovery.
10.1179/2046905512Y.0000000011
Retrograde pyelonephritis and lumbar spondylitis as a result of Salmonella typhi in a type 2 diabetes patient with neurogenic bladder.
Fukuda Tatsuya,Bouchi Ryotaro,Minami Isao,Ohara Norihiko,Nakano Yujiro,Nishitani Rie,Murakami Masanori,Takeuchi Takato,Akihisa Momoko,Fujita Masamichi,Izumiyama Hajime,Hashimoto Koshi,Yoshimoto Takanobu,Ogawa Yoshihiro
Journal of diabetes investigation
We present a case of a 62-year-old diabetic woman with acute pyelonephritis and spondylitis caused by Salmonella typhi. She was admitted to Tokyo Medical Dental University Hospital, Tokyo, Japan, because of unconsciousness and was diagnosed with sepsis by retrograde pyelonephritis as a result of Salmonella typhi. Antibiotics treatment was immediately started; however, she subsequently developed lumbar spondylitis, and long-term conservative treatment with antibiotics and a fixing device were required. This is the first report of a diabetic patient who developed retrograde urinary tract infection with Salmonella typhi, followed by sepsis and spondylitis. The infection could be a result of diabetic neuropathy, presenting neurogenic bladder and hydronephrosis. The patient was successfully treated with antibiotics and became asymptomatic with normal inflammatory marker levels, and no clinical sign of recurrence was observed in the kidney and spine at 4 months.
10.1111/jdi.12375
Indolent Non-Typhoidal Salmonella Vertebral Osteomyelitis in a Diabetic Patient.
Matono Takashi,Takeshita Nozomi,Kutsuna Satoshi,Fujiya Yoshihiro,Mawatari Momoko,Hayakawa Kayoko,Kanagawa Shuzo,Ohmagari Norio,Kato Yasuyuki
Internal medicine (Tokyo, Japan)
We herein describe the case of a 59-year-old Japanese man with diabetes mellitus who presented with vertebral osteomyelitis caused by Salmonella enterica subspecies enterica serovar Enteritidis. The patient presented with a persistent fever without back pain. Extraintestinal infections of Salmonella species are well known and are often reported in immunocompromised patients; however, they are rare in non-immunosuppressed patients. The protracted course and atypical presentation of osteomyelitis in diabetic adults can lead to major diagnostic delays. Moreover, in recent years, decreased fluoroquinolone susceptibility against salmonellosis has become a problem worldwide, a problem that needs to be urgently addressed.
10.2169/internalmedicine.54.4833
Infective lumbar discitis in a sickler--an occult 'typhoid' spine?
Alonge T O,Ogunlade S O,Omololu A B,Obajimi M
West African journal of medicine
Pyogenic infection of the intervertebral disc (discitis) is a rare infection and the diagnosis often depends on a high index of suspicion. The cases of infective discitis described in the modern literature are similar to, if not identical with what was described as 'typhoid spine'. Salmonella infection of the musculoskeletal system on the other hand is more common in patients with sickle cell anaemia. This case report highlights the bizarre presentation of infective lumbar discitis in a sickler (HbSS) and calls attention to the need for a thorough evaluation of low back pain in these patients.
10.4314/wajm.v22i3.27964
Invasive non-typhoidal infection complicated by metastatic infections: Report of three cases.
IDCases
Non-typhoidal (NTS) disease is usually a self-limiting infection presenting with digestive symptoms. However, disseminated presentation with involvement of secondary infectious sites is observed. We report diagnostic specificities and challenges related to the management of three patients with invasive NTS (iNTS) and secondary infectious locations. Among the seven patients (age range 46 - 83 years), four (two with extra-digestive infectious sites) had at least one immune debilitating condition. Two patients were incidentally discovered with iNTS and deceased after developing a septic shock despite antimicrobial treatment. Two individuals recovered under medical treatment without complications. Three other patients presented with secondary infectious sites. Case 1 suffered from urinary tract infection and dorsolumbar spondylodiscitis that responded well to antimicrobials and surgery. Abdominal prosthetic aortic aneurysm was diagnosed in case 2 and medical treatment only was applied. After four years of follow-up, he remains under antimicrobial treatment. Case 3 presented with conjoint thoracic aortic aneurysm and cutaneous abscesses managed with antimicrobials and surgery. Atherosclerosis and previous vascular intervention were the predisposing events for vascular involvement. iNTS is a serious disease carrying a high risk of mortality or secondary locations. Secondary locations can be managed by long duration antimicrobial therapy combined with surgery. Spine and aortitis are the most frequent secondary locations. Multi-drug resistant NTS represent an additional risk of mortality. Public health measures should be implemented to limit the spread of NTS to humans and the emergence of drug resistance.
10.1016/j.idcr.2022.e01498
Typhoid osteomyelitis of the lumbar spine.
Khan F Y,El-Hiday A H,Kamel H A
Hong Kong medical journal = Xianggang yi xue za zhi
A 25-year-old Nepali man presented with a 20-day history of fever associated with a lower backache. Physical examination found tenderness over the lower lumbar vertebrae. Magnetic resonance imaging following intravenous contrast injection showed enhancement of the L4 and L5 vertebrae, particularly pronounced around the intervening disc, and areas of endplate erosion. Extra-vertebral enhancement and a small subligamentous anterior collection were also noted. Computed tomography-guided needle aspiration was performed at the level of L4/5 disc material and culture of the specimen grew Salmonella typhi sensitive to ampicillin, ciprofloxacin, and ceftriaxone. The patient received intravenous ampicillin 2 g per 4 hours for 6 weeks. The back pain resolved completely and the patient was discharged. Typhoid osteomyelitis of the spine should be considered in the differential diagnosis in patients from endemic areas who present with fever and backache.
Salmonella spondylodiscitis in the immunocompetent: our experience with eleven patients.
Amritanand Rohit,Venkatesh K,Sundararaj Gabriel D
Spine
STUDY DESIGN:Retrospective case series. OBJECTIVE:To report the clinical features, diagnostic dilemmas and management options of 11 immunologically normal patients with salmonella spondylodiscitis. SUMMARY OF BACKGROUND DATA:Majority of existing data on salmonella spondylodiscitis in the immunologically normal patient is from anecdotal case report. METHODS:From 1995 to 2008, 11 patients with salmonella spondylodiscitis proven by positive culture, biopsy, and Widal test were included. One patient died, and the average follow-up of the remaining 10 patients was 36 months (12-122 months). Five (50%) patients had a documented history of typhoid fever. Intravenous antibiotics for 2 weeks and oral antibiotics for at least 10 weeks were given to all patients. Indications for surgical intervention were unrelenting pain and osseous instability. Clinical outcome was evaluated according to Macnab criteria. RESULTS:Salmonella typhi was cultured in 4 and S. Paratyphi in 5 patients. No organism was identified in 2 patients, on whom the diagnosis was performed by a characteristic history, high Widal titers, and a positive biopsy. Widal titers were positive for all patients (Average + 1360). Five patients were managed with antibiotics only, 1 with surgical debridement and uninstrumented fusion and 4 with single-stage debridement, anterior fusion, and posterior instrumentation. Healing of disease with a good to excellent outcome was seen in all patients. CONCLUSION:Salmonella and tuberculous spondylitis must be differentiated as they both have similar epidemiological and clinicoradiologic presentations. Prodromal gastrointestinal symptoms are usually not present. The diagnosis rests largely on the recovery of the organism by appropriate culture techniques. However, when this is not apparent the Widal test, in the setting of a suggestive history and radiograph, may be used as a diagnosis tool. Though antibiotics are the mainstay of treatment, surgical debridement with the use of instrumentation may be indicated in selected patients.
10.1097/BRS.0b013e3181e87afe
Typhoid spine - a case report.
Rajesh P K,Mythili S,Subramaniam L
Indian journal of medical microbiology
A case of Salmonella typhi isolated from L4-L5 spine is reported here. The causative organism was not suspected preoperatively. The patient responded favourably to surgical drainage and appropriate antibiotic therapy.
Typhoid spondylodiscitis of the cervical spine.
BMJ case reports
Spinal infection comprises pyogenic and non-pyogenic spondylodiscitis. This condition may manifest with non-specific clinical symptoms, elevated infective parameters and imaging findings that are difficult to distinguish. The cornerstone of a definitive diagnosis and subsequent successful treatment lies in tissue analysis through culture and histopathological studies. In this context, we present a case of Salmonella pyogenic spondylodiscitis affecting the C5/C6 vertebrae, complicated by Salmonella bacteraemia and characterised by mechanical neck pain that curtails daily activities and overall functioning, although without neurological deficits. The uniqueness of this case stems from its occurrence in an immunocompetent individual from a non-endemic area, with no identifiable sources of Salmonella infection or preceding gastrointestinal symptoms.
10.1136/bcr-2023-255033
Chronic osteomyelitis of the thoracic spine due to Salmonella typhi: a case report.
Carvell J E,Maclarnon J C
Spine
A young woman with a 12-year history of symptoms of osteomyelitis of her spine had been treated for unproven tuberculous disease. During an acute flare-up of her symptoms, bacteriologic proof of Salmonella typhi infection was obtained, and the patient was treated with chloramphenicol and amoxycillin. The case illustrates the difficulties involved in making a radiologic diagnosis and the value of obtaining bacteriologic identification of the organism.