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Muscle infections caused by Salmonella species: case report and review
J Collazos1, J Mayo, E Martínez
1Section of Infectious Diseases, Hospital de Galdakao, Vizcaya, Spain.
Abstract:
We describe a patient with salmonella pyomyositis and review 30 other cases reported during the past 4 decades. Men outnumbered women by 2.9 to 1, and the median age of the patients was 51 years. Approximately one-half the cases were caused by Salmonella enteritidis. Infected vascular aneurysms were observed in seven patients. Prior salmonella infections and local trauma or lesions were common. Diverse underlying conditions, mainly diabetes and human immunodeficiency virus infection, were present in 81% of the patients, and the psoas muscle was involved in 55% of the cases. One-third of the patients died, and relapses were common after a median time of 5 weeks (range, 4.5-27 weeks) in those who survived. Most patients had anemia, and pathogens were recovered from blood samples from two-thirds of the patients. Salmonella should be considered as a causative agent of muscle infections in the appropriate clinical setting, particularly in patients with underlying diseases or preexisting vascular aneurysms.
Insights
Salmonella pyomyositis, a serious muscle infection, often affects older men with underlying conditions like diabetes or HIV. Prompt diagnosis and treatment are crucial due to high mortality and relapse rates.
Area of Science:
- Infectious Diseases
- Musculoskeletal Infections
- Bacterial Pathogenesis
Background:
- Salmonella pyomyositis is a rare but severe bacterial infection of the muscle.
- Understanding risk factors and clinical presentations is crucial for early diagnosis and management.
Observation:
- Review of 31 cases (including one new case) over four decades.
- Predominant in males (2.9:1 ratio), median age 51 years.
- Salmonella enteritidis was the most common serotype, accounting for half of cases.
Findings:
- Commonly associated with underlying conditions (81%), notably diabetes and HIV infection.
- Psoas muscle involvement occurred in 55% of cases; vascular aneurysms in 7 patients.
- High mortality (one-third) and frequent relapses (median 5 weeks) observed.
Implications:
- Salmonella should be considered in muscle infections, especially in immunocompromised individuals or those with vascular issues.
- Anemia and positive blood cultures are frequent findings.
- Highlights the need for vigilance in diagnosing and treating this potentially life-threatening infection.