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Salmonella Typhi sternoclavicular abscess with osteomyelitis-a rare case report
Isabella Princess1, Nikhil Pollo Jaik Theckumparampil2, Suresh Kumar Dorairajan3
1Department of Microbiology, Apollo Speciality Hospitals, Vanagaram, Chennai, 600095 India.
Abstract:
Salmonella Typhi osteomyelitis is a rare occurrence as compared to enteric fever and diarrhoea which are common manifestations caused by this microorganism. In reported cases of Salmonella osteomyelitis, commonly involved sites are long bones like the femur and humerus. Uncommon reports of Salmonella osteomyelitis from sites such as radius, ulna, tibia and vertebrae have also emerged. Extremely rare incidences of the same have been reported from the clavicle, skull and small bones of hands. Osteomyelitis could be bacterial or non-bacterial, and among bacterial osteomyelitis, Salmonella Typhi is a very rare entity. We present a case of Salmonella osteomyelitis and discuss the importance of microbiological diagnosis of osteomyelitis in diagnosing unusual pathogens from unusual sites. This case report is unique due to its site and difference in clinical presentation. The difference in presentation in an elderly immunocompetent male with no major comorbidities was different from other reported cases. Our patient was successfully managed with surgical debridement followed by a series of vacuum dressings and intravenous antibiotics for 6 weeks.
Insights
Salmonella Typhi osteomyelitis is rare, especially in unusual bone sites. This case highlights the importance of microbiological diagnosis for identifying rare pathogens in unexpected locations.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Salmonella Typhi commonly causes enteric fever and diarrhea.
- Osteomyelitis is inflammation of the bone, which can be bacterial or non-bacterial.
- Salmonella Typhi osteomyelitis is a rare complication, with long bones being the most frequent sites of infection.
Observation:
- This case report details an extremely rare instance of Salmonella Typhi osteomyelitis in an unusual bone site.
- The patient, an elderly immunocompetent male with no significant comorbidities, presented with a unique clinical manifestation.
- The diagnosis was confirmed through microbiological examination, emphasizing the importance of identifying unusual pathogens.
Findings:
- The patient was successfully treated with surgical debridement.
- Vacuum-assisted closure (VAC) dressings were utilized as part of the wound management strategy.
- Intravenous antibiotics were administered for a duration of six weeks, leading to a positive outcome.
Implications:
- This case underscores the necessity of considering rare pathogens like Salmonella Typhi in the differential diagnosis of osteomyelitis, particularly from unusual anatomical locations.
- The findings emphasize the critical role of microbiological investigations in diagnosing and managing atypical infections.
- Effective management involves a combination of surgical intervention, advanced wound care, and targeted antibiotic therapy.
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