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Spectrum of Salmonella-associated arthritis
Insights
Salmonella infection can cause distinct types of arthritis, including suppurative arthritis and reactive arthritis like Reiter's syndrome. Early recognition and treatment are crucial for managing these uncommon Salmonella-associated joint complications.
Area of Science:
- Infectious Diseases
- Rheumatology
- Microbiology
Background:
- Salmonella infection is a common cause of gastroenteritis.
- Extraintestinal manifestations of Salmonella are less common but can be severe.
- Arthritis is an infrequent but significant extraintestinal complication of Salmonella.
Observation:
- Three pediatric cases of Salmonella-associated arthritis were observed within an 11-month period.
- Case 1: Suppurative arthritis due to Salmonella typhimurium requiring surgical intervention and antibiotics.
- Case 2: Migratory polyarthritis following Salmonella infection, resolving with anti-inflammatory treatment.
- Case 3: Reiter's syndrome (conjunctivitis, urethritis, polyarthritis) associated with Salmonella gastroenteritis.
Findings:
- Salmonella can cause diverse forms of arthritis, including septic arthritis and reactive arthritis.
- Salmonella typhimurium was identified as the causative agent in suppurative and migratory polyarthritis cases.
- Reiter's syndrome is a recognized, albeit uncommon, manifestation of Salmonella gastroenteritis.
Implications:
- Highlights the spectrum of joint involvement in Salmonella infections.
- Emphasizes the need for considering Salmonella in the differential diagnosis of arthritis, especially post-gastroenteritis.
- Underscores the importance of appropriate diagnostic workup and tailored treatment for Salmonella-associated joint disease.
Abstract:
Arthritis is an uncommon extraintestinal manifestation of Salmonella infection. Three patients with Salmonella-associated arthritis with varying manifestations were seen at Children's Hospital Medical Center in an 11-month period: (1) a 12-year-old girl developed suppurative arthritis due to Salmonella typhimurium that required surgical drainage and prolonged parenteral antibiotic therapy; (2) a 12-year-old girl had migratory polyarthritis following gastrointestinal infection with S typhimurium; the acute synovitis subsided after a six-month period following anti-inflammatory medications; (3) a 14-year-old girl developed conjunctivitis, urethritis, and polyarthritis (Reiter's syndrome) in association with Salmonella gastroenteritis. These patients illustrate the distinct types of arthritis associated with Salmonella gastroenteritis. These patients illustrate that distinct types of arthritis associated with Salmonella, and the association of this organism with both suppurative joint disease and reactive arthritis is reemphasized.