Salmonella osteomyelitis in a patient with systemic lupus erythematosus

This paper describes a case of osteomyelitis due to Salmonella bovis morbificans in a patient with systemic lupus erythematosus (SLE) on long-term corticosteroid therapy. Although the organism was susceptible in vitro to chloramphenicol, ampicillin and co-trimoxazole, therapy with any of these drugs became impossible due to severe allergic reactions. A prolonged course of trimethoprim coupled with surgical debridement cured the lesion. The serum concentration of trimethoprim 24 hours after administration of a single oral dose of 300 mg was over four times the minimum inhibitory concentration (MIC) of the Salmonella sp. involved. These results indicate that trimethoprim may be effective in the treatment of Salmonella osteomyelitis.