Atypical osteomyelitis and concurrent septic arthritis due to Salmonella in immunocompetent children

Salmonella osteomyelitis in immunocompromised individuals with sickle cell anaemia is well documented. Its occurrence in immunocompetent children is rare.

All pus culture positive cases of salmonella typhi between the period 2009 to 2014 were reviewed and only those children without sickle cell disease or trait were considered further.

Eighty five patients had positive cultures. Of these only three children had culture positive Salmonella septic arthritis in the absence of sickle cell disease. Two children had shoulder septic arthritis while one had hip septic arthritis.

Our case series highlights the possibility of salmonella typhi osteomyelitis in immunocompetent individuals. Clinicians should be aware of this presentation which is usually delayed due to the atypical organism and lack of clinical response in the initial stages, as disastrous sequelae of septic arthritis may result if prompt treatment is not initiated in time.