Salmonella vertebral osteomyelitis: a complication of salmonella aortitis

Salmonella vertebral osteomyelitis of the lumbar spine is encountered as a complication of Salmonella arteritis. Salmonella organisms, especially those of the choleraesuis and typhimurium species, invade the lamina intima of a diseased or atherosclerotic abdominal aorta, penetrate its wall, and cause the formation of a mycotic aneurysm. Further spread of thé infectious process through the aneurysmal aortic wall leads to infection of the retroperitoneum, psoas abscess formation, and osteomyelitis of the adjacent lumbar vertebrae. A review of the literature reveals a 77% mortality rate. Successful treatment of this association requires resection of the abdominal aneurysm and debridement of the retroperitoneum, extra-anatomic bypass grafting, and appropriate antimicrobial therapy.Key Indexing Terms: Salmonella Vertebral Osteomyelitis; Salmonella Aortitis; Mycotic Aortic Aneurysm.