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Updated: Mar 30, 2026
Chronic Salmonella Infection Induced Intestinal Fibrosis
Published on: September 22, 2019
[A Case of Osteomyelitis with a Granulomatous Lesion Caused by Salmonella Infantis]
Abstract:
We report herein on a case of osteomyelitis with a granulomatous lesion caused by Salmonella enterica subsp. enterica serovar Infantis (Salmonella Infantis). A 30-year-old Japanese man presenting with a 3-week history of left ankle pain was suspected to have either a tumor or osteomyelitis, on the basis of imaging study findings. He underwent a surgical resection of the lesion. Histopathological examination revealed a granuloma. However, S. Infantis was cultured from the biopsy sample. Cefazolin was initially administered as empirical therapy. We switched the antibiotic to ampicillin on the basis of the anitibiotic-susceptibility test results. Six weeks after intravenous ampicillin therapy, we switched to oral ciprofloxacin. He has had no recurrence in the 3 years after treatment completion. Salmonella osteomyelitis is rare and this pathogen seldom causes a granulomatous lesion. According to the findings in our case, Salmonella spp. should be considered as one of the differential diagnoses for granulomatous lesions in the bone.
Insights
This case study highlights Salmonella Infantis osteomyelitis presenting as a rare granulomatous bone lesion. Prompt antibiotic treatment led to a successful recovery, emphasizing Salmonella
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Osteomyelitis, a bone infection, can be challenging to diagnose, especially when presenting with atypical features.
- Granulomatous lesions in bone typically suggest other etiologies like tumors or specific infections.
Observation:
- A 30-year-old man presented with left ankle pain, initially suspected as a tumor or osteomyelitis based on imaging.
- Surgical resection revealed a granulomatous lesion, but Salmonella enterica subsp. enterica serovar Infantis (Salmonella Infantis) was cultured from the biopsy.
- The patient received empirical cefazolin, followed by ampicillin based on susceptibility, and later oral ciprofloxacin.
Findings:
- This case demonstrates Salmonella Infantis causing osteomyelitis with a granulomatous manifestation, a rare occurrence.
- Histopathological examination confirmed a granuloma, while microbiological analysis identified Salmonella Infantis as the causative agent.
- Successful treatment involved a tailored antibiotic regimen, including ampicillin and ciprofloxacin.
Implications:
- Salmonella species should be considered in the differential diagnosis of bone granulomatous lesions.
- This case expands the understanding of Salmonella osteomyelitis presentations and its potential to cause granulomas.
- Effective management relies on accurate microbiological diagnosis and appropriate antibiotic therapy.
