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Salmonella typhi osteomyelitis
J Declercq1, J Verhaegen, L Verbist
1Department of Microbiology, University Hospital St Rafaël, Leuven, Belgium.
Abstract:
Salmonella infections in man can be divided in five clinical groups: enteric fever, septicaemia without localization, focal disease, gastroenteritis and the carrier state. Salmonella typhi is mostly associated with enteric fever and the carrier state. Bone infections due to S. typhi have been reported relatively seldom. They usually occur as the result of metastatic spread during septicaemia or, more rarely, after direct inoculation. Two patients with S. typhi osteomyelitis of the forearm without evidence of a primary infection or direct inoculation are presented here.
Insights
Salmonella typhi rarely causes bone infections. This study presents two forearm osteomyelitis cases in patients without a clear primary infection or direct inoculation, highlighting unusual presentations of Salmonella typhi bone disease.
Area of Science:
- Infectious Diseases
- Bacteriology
- Orthopedics
Background:
- Salmonella infections manifest in various clinical forms, including enteric fever, gastroenteritis, and carrier states.
- Salmonella typhi is primarily linked to enteric fever and chronic carriage.
- Osteomyelitis, or bone infection, due to Salmonella typhi is uncommon.
Observation:
- Bone infections typically arise from metastatic spread during septicemia or direct inoculation.
- This report details two cases of Salmonella typhi osteomyelitis affecting the forearm.
- Neither patient presented with evidence of a preceding systemic infection or direct inoculation trauma.
Findings:
- The study identified two unique cases of Salmonella typhi osteomyelitis of the forearm.
- These cases occurred without the usual preceding conditions of septicemia or direct inoculation.
- This suggests alternative pathways for Salmonella typhi to cause focal bone infection.
Implications:
- These findings expand the understanding of Salmonella typhi pathogenesis in bone infections.
- Clinicians should consider Salmonella typhi in the differential diagnosis of forearm osteomyelitis, even in the absence of typical risk factors.
- Further research is warranted to elucidate the mechanisms behind non-metastatic, non-traumatic Salmonella typhi osteomyelitis.