Salmonella osteomyelitis in an immunocompromized patient presenting as a primary lymphoma of the bone

During the past few decades, an increasing number of immunosuppressive drugs have been developed to treat autoimmune and rheumatic diseases, as well as post-transplant patients. In parallel, the incidence of immunocompromized patients in the general population has risen, for example, patients who are HIV positive, undergoing hemodialysis or suffering from diabetes mellitus. In such predisposed patients, infections with organisms of even reduced invasive potential can result in atypical invasive manifestations. In industrialized countries, an increase in the number of human non-typhoid Salmonella infections was observed in the 1980-1990s [Shimoni Z, Pitlik S, Leibovici L, Samra Z, Konigsberger H, Drucker M, et al. Nontyphoid Salmonella bacteremia: age-related differences in clinical presentation, bacteriology, and outcome. Clin Infect Dis 1999;28:822-7]. Beyond the main clinical manifestation of gastroenteritis, there is an increasing prevalence of extra-intestinal infections by this pathogen. We report a patient with acute osteomyelitis due to Salmonella typhimurium without any previous signs of gastroenteritis.