Salmonella Infection Arising From a Wound in an Infant: A Case Report

Bilateral hand cellulitis is an uncommon manifestation of Salmonella infection, particularly in pediatric patients. While Salmonella is typically associated with gastrointestinal symptoms, extraintestinal infections such as cellulitis are rare and pose diagnostic challenges. These atypical presentations highlight the clinical diversity of Salmonella species and underscore the need for timely and targeted management. A previously healthy one-year-old girl presented with progressive swelling, redness, and warmth in both hands, accompanied by fever. There was no history of trauma, insect bites, or gastrointestinal symptoms. Initial laboratory investigations revealed no systemic abnormalities, and wound cultures identified Salmonella Group D as the causative pathogen. The infection did not respond to initial empirical topical therapy, necessitating a transition to targeted systemic antibiotics based on culture sensitivity. Given the severity of the condition and poor response to conservative management, the patient underwent bilateral incision and drainage under general anesthesia. Intraoperative findings confirmed the diagnosis, and postoperative care included wound dressing, pain management, and supportive measures. The patient showed steady improvement, with complete resolution of symptoms following a full course of antibiotics and surgical intervention. This case underscores the importance of considering Salmonella in the differential diagnosis of cellulitis, even in pediatric patients without typical risk factors such as trauma or immunosuppression. Early diagnosis, pathogen-directed antibiotic therapy, and surgical intervention are essential for managing such rare presentations. Increased awareness and parental education on infection prevention are critical to reducing the burden of Salmonella-related complications in vulnerable populations. This case contributes to the growing literature on the diverse clinical presentations of Salmonella.