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Salmonella osteomyelitis after internal fixation of fracture
1Department of Orthopaedic Surgery B, Chaim Sheba Medical Center, Tel-Hashomer, Israel.
Abstract:
A patient with Salmonella group D (Salmonella enteritidis) acute osteomyelitis of an operated femur is described. The patient failed to respond to chloramphenicol therapy and aztreonam therapy. The local infection that complicated the presence of a foreign body was eradicated only with the removal of the foreign body, an internal fixation plate.
Insights
Salmonella enteritidis osteomyelitis in a surgically treated femur resisted antibiotic treatment. Eradicating the infection required removing the internal fixation plate, highlighting the role of foreign bodies in persistent bone infections.
Area of Science:
- Orthopedic Surgery
- Infectious Diseases
- Microbiology
Background:
- Osteomyelitis is a serious bone infection.
- Surgical interventions for bone fractures often involve internal fixation devices.
- Foreign bodies can complicate infection management.
Observation:
- A patient presented with acute Salmonella group D (Salmonella enteritidis) osteomyelitis in a previously operated femur.
- The infection was localized around an internal fixation plate.
- The patient did not respond to chloramphenicol or aztreonam therapy.
Findings:
- The persistent Salmonella enteritidis infection was refractory to standard antibiotic regimens.
- Complete eradication of the local infection was achieved only after the removal of the internal fixation plate.
- The presence of the foreign body (internal fixation plate) was a critical factor in the treatment failure.
Implications:
- This case underscores the importance of considering foreign body involvement in refractory osteomyelitis.
- Removal of orthopedic implants may be necessary for successful treatment of deep-seated bone infections.
- Effective management of Salmonella enteritidis osteomyelitis in the context of orthopedic hardware requires a multidisciplinary approach.