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Salmonella Osteomyelitis in a one year old Child without Sickle Cell Disease: A Case Report
C Saturveithan1, A Arieff1, G Premganesh1
1Depertment of Orthopaedics, Malacca Hospital, Malacca, Malaysia.
Insights
This case study highlights a rare instance of Salmonella osteomyelitis in a child without sickle cell disease. Prompt diagnosis and a combination of antibiotics and surgery led to a full recovery.
Area of Science:
- Pediatric Infectious Diseases
- Musculoskeletal Infections
Background:
- Salmonella osteomyelitis is uncommon in children, particularly those without sickle cell disease.
- Early recognition and intervention are crucial for favorable outcomes.
Purpose of the Study:
- To report a rare case of Salmonella osteomyelitis and septic arthritis in a pediatric patient.
- To emphasize the diagnostic and therapeutic approach for this condition.
Main Methods:
- Clinical presentation of a one-year-old boy with shoulder pain and limited motion.
- Laboratory investigations including inflammatory markers and synovial fluid analysis.
- Radiological imaging (X-ray, MRI) to diagnose osteomyelitis and septic arthritis.
- Microbiological culture identifying Salmonella species.
Main Results:
- Initial presentation mimicked other inflammatory conditions, delaying specific diagnosis.
- MRI confirmed acute osteomyelitis and concurrent septic arthritis of the shoulder.
- Salmonella species were identified from arthrotomy washout cultures.
- The patient responded well to a six-week course of intravenous ampicillin and sulbactam.
Conclusions:
- Salmonella osteomyelitis can occur in non-sickle cell disease pediatric patients.
- A combination of advanced imaging, microbiological analysis, and appropriate antibiotic therapy is essential for successful treatment.
- Early surgical intervention alongside antibiotics can improve outcomes in complex cases.
Abstract:
A one year old boy was admitted with left shoulder pain with reduced range of motion of five days' duration associated. Inflammatory markers were raised and radiograph of the left shoulder revealed widening of the metaphysis of the proximal humerus. Empirically, he was started on intravenous C-penicillin and cloxacillin after initial joint aspiration yielded only synovial fluid with negative culture. Subsequent MRI revealed acute osteomyelitis of the proximal left humerus with concurrent septic arthritis of the shoulder joint. Cultures from the arthrotomy washout grew Salmonella sp, sensitive to ampicillin. He recovered following six weeks of intravenous unasyn ( ampicillin and sulbactum). This rare case of salmonella osteomyelitis in a non-sickle cell disease patient was diagnosed with serial laboratory and radiological studies and was successfully treated with adequate duration of antibiotics and operative intervention.
Key Words:
salmonella osteomyelitis, non-sickle cell disease, children.
