Salmonellosis osteomyelitis of the pelvic bones in adolescent: a case report

Abstract

Salmonellosis osteomyelitis is a rare form of extraintestinal salmonellosis in children that occurs against the background of sepsis. This article presents observation of salmonellosis osteomyelitis in a previously healthy 17-year-old patient. The patient experienced pain in the right lower limb with restriction of its mobility. Magnetic resonance imaging revealed bone-destructive changes in the lumbosacral spine. Thrombocytopenia progressed to 60×10⁹/l. In the oncohematologic domain, secondary character of thrombocytopenia was established, and iliac–lumbar muscle abscesses were found. The child was transferred to a surgical hospital, and sepsis, osteomyelitis of the right lateral mass of the sacrum, right-sided sacroiliitis, abscess of the right iliopsoas muscle, bilateral polysegmental pneumonia, and bilateral pleuritic were diagnosed. Surgical opening and drainage of the abscess of the lumbosacral muscle was performed. The study of abscess secretion detected Salmonella gr. B Chester, a resistance gene to penicillins, cephalosporins, and carbapenems. Therapy with off-label ciprofloxacin at 400 mg with pronounced positive dynamics. Cases of treatment of patients with atypical forms of salmonellosis show the need for further accumulation of experience, modification of treatment protocols, and verification of pathogens at an early stage for greater therapy effectiveness.

Keywords

Salmonella infections / atypical localization of salmonellosis / sepsis / salmonellosis osteomyelitis / psoas abscess / children / case report

References

[1] Yushchuk ND, Vengerov YuYa, ed. Infectious diseases: national manual. Moscow: GEOTAR-Media; 2019. 848 p. (In Russ.)

[2] Инфекционные болезни: национальное руководство. 2-е изд., перераб. и доп. / под ред. Н.Д. Ющука, Ю.Я. Венгерова. Москва: ГЭОТАР-Медиа, 2019. 848 с.

[3] Yushchuk ND, Vengerov YuYa, ed. Infectious diseases: national manual. Moscow: GEOTAR-Media; 2019. 848 p. (In Russ.)

[4] Lobzin YuV, Uskov AN, Bekhtereva MK, et al. Clinical guidelines: Salmonellosis in children. Saint Petersburg; 2021. 44 p. (In Russ.)

[5] Лобзин Ю.В., Усков А.Н., Бехтерева М.К., и др. Клинические рекомендации: Сальмонеллез у детей. Санкт-Петербург, 2021. 44 с.

[6] Lobzin YuV, Uskov AN, Bekhtereva MK, et al. Clinical guidelines: Salmonellosis in children. Saint Petersburg; 2021. 44 p. (In Russ.)

[7] Zhan C, Du J, Chen L. Salmonella osteomyelitis in a previously healthy neonate: a case report and review of the literature. Ital J Pediatr. 2018;44:28. doi: 10.1186/s13052-018-0464-2

[8] Zhan C., Du J., Chen L. Salmonella osteomyelitis in a previously healthy neonate: a case report and review of the literature // Ital J Pediatr. 2018. Vol. 44. ID 28. doi: 10.1186/s13052-018-0464-2

[9] Zhan C, Du J, Chen L. Salmonella osteomyelitis in a previously healthy neonate: a case report and review of the literature. Ital J Pediatr. 2018;44:28. doi: 10.1186/s13052-018-0464-2

[10] Tsagris V, Vliora С, Mihelarakis I, et al. Salmonella osteomyelitis in previously healthy children: Report of 4 cases and review of the literature. Pediatr Infect Dis J. 2016;35(1):116–117. doi: 10.1097/INF.0000000000000937

[11] Tsagris V., Vliora С., Mihelarakis I., et al. Salmonella osteomyelitis in previously healthy children: Report of 4 cases and review of the literature // Pediatr Infect Dis J. 2016. Vol. 35, N. 1. P. 116–117. doi: 10.1097/INF.0000000000000937

[12] Tsagris V, Vliora С, Mihelarakis I, et al. Salmonella osteomyelitis in previously healthy children: Report of 4 cases and review of the literature. Pediatr Infect Dis J. 2016;35(1):116–117. doi: 10.1097/INF.0000000000000937

[13] Galkevich NV, Halabarodzka NV, Astapov AA, et al. Invasive (extra-intestinal) non-typhoidal salmonella (INTS) disease in children: case series. Clinical infectology and parasitology. 2018;7(2):211–223. EDN: XUKPAD

[14] Галькевич Н.В., Голобородько Н.В., Астапов А.А., и др. Инвазивный (внекишечный) сальмонеллез у детей: серия клинических случаев // Клиническая инфектология и паразитология. 2018. Т. 7, № 2. С. 211–223. EDN: XUKPAD

[15] Galkevich NV, Halabarodzka NV, Astapov AA, et al. Invasive (extra-intestinal) non-typhoidal salmonella (INTS) disease in children: case series. Clinical infectology and parasitology. 2018;7(2):211–223. EDN: XUKPAD

[16] Morozova OL, Gisak SN, Morrison BB, et al. Features of the course of acute haematogenous osteomyelitis in young children. Saratov journal of medical scientific research. 2007;3(2):29–35. EDN: JUTIBR

[17] Морозова О.Л., Гисак С.Н., Моррисон В.В., и др. Особенности течения острого гематогенного остеомиелита у детей младшего возраста // Саратовский научно-медицинский журнал. 2007. Т. 3, № 2. С. 29–35. EDN: JUTIBR

[18] Morozova OL, Gisak SN, Morrison BB, et al. Features of the course of acute haematogenous osteomyelitis in young children. Saratov journal of medical scientific research. 2007;3(2):29–35. EDN: JUTIBR

[19] Vynichakis G, Chandrinos M, Angelis S, et al. Salmonella osteomyelitis of the proximal tibia in a previously healthy adolescent: A case report. Cureus. 2019;11(9):e5672. doi: 10.7759/cureus.5672

[20] Vynichakis G., Chandrinos M., Angelis S., et al. Salmonella osteomyelitis of the proximal tibia in a previously healthy adolescent: A case report // Cureus. 2019. Vol. 11, N. 9. ID e5672. doi: 10.7759/cureus.5672

[21] Vynichakis G, Chandrinos M, Angelis S, et al. Salmonella osteomyelitis of the proximal tibia in a previously healthy adolescent: A case report. Cureus. 2019;11(9):e5672. doi: 10.7759/cureus.5672

[22] Eng S-K, Pusparajah P, Mutalib N-SA, et al. Salmonella: A review on pathogenesis, epidemiology and antibiotic resistance. Front Life Sci. 2015;8(3):284–293. doi: 10.1080/21553769.2015.1051243

[23] Eng S.-K., Pusparajah P., Mutalib N.-S.A., et al. Salmonella: A review on pathogenesis, epidemiology and antibiotic resistance // Front Life Sci. 2015. Vol. 8, N. 3. P. 284–293. doi: 10.1080/21553769.2015.1051243

[24] Eng S-K, Pusparajah P, Mutalib N-SA, et al. Salmonella: A review on pathogenesis, epidemiology and antibiotic resistance. Front Life Sci. 2015;8(3):284–293. doi: 10.1080/21553769.2015.1051243

[25] Andrews-Polymenis HL, Bäumler AJ, McCormick BA, Fang FC. Taming the elephant: salmonella biology, pathogenesis, and prevention. Infect Immun. 2010;78(6):2356–2369. doi: 10.1128/IAI.00096-10

[26] Andrews-Polymenis H.L., Bäumler A.J., McCormick B.A., Fang F.C. Taming the elephant: salmonella biology, pathogenesis, and prevention // Infect Immun. 2010. Vol. 78, N. 6. P. 2356–2369. doi: 10.1128/IAI.00096-10

[27] Andrews-Polymenis HL, Bäumler AJ, McCormick BA, Fang FC. Taming the elephant: salmonella biology, pathogenesis, and prevention. Infect Immun. 2010;78(6):2356–2369. doi: 10.1128/IAI.00096-10

[28] Delori M, Abgueguen P, Chennebault J-M, et al. Breast abscess with Salmonella typhi and review of the literature. J Gynecol Obstet Biol Reprod (Paris). 2007;36(7):709–712. doi: 10.1016/j.jgyn.2007.04.013

[29] Delori M., Abgueguen P., Chennebault J.-M., et al. Breast abscess with Salmonella typhi and review of the literature // J Gynecol Obstet Biol Reprod (Paris). 2007. Vol. 36, N. 7. P. 709–712. doi: 10.1016/j.jgyn.2007.04.013

[30] Delori M, Abgueguen P, Chennebault J-M, et al. Breast abscess with Salmonella typhi and review of the literature. J Gynecol Obstet Biol Reprod (Paris). 2007;36(7):709–712. doi: 10.1016/j.jgyn.2007.04.013

[31] Guiney DG, Fierer J. The role of the SPV genes in salmonella pathogenesis. Front Microbiol. 2011;14(2):129. doi: 10.3389/fmicb.2011.00129

[32] Guiney D.G., Fierer J. The role of the SPV genes in salmonella pathogenesis // Front Microbiol. 2011. Vol. 14, N. 2. ID 129. doi: 10.3389/fmicb.2011.00129

[33] Guiney DG, Fierer J. The role of the SPV genes in salmonella pathogenesis. Front Microbiol. 2011;14(2):129. doi: 10.3389/fmicb.2011.00129

[34] Okulich VK, Kabanova AA, Plotnikov FV. Microbial biofilms in clinical microbiology and antibacterial therapy. Vitebsk: VSMU; 2017. 300 p. (In Russ.)

[35] Окулич В.К., Кабанова А.А., Плотников Ф.В. Микробные биопленки в клинической микробиологии и антибактериальной терапии. Витебск: ВГМУ, 2017. 300 с.

[36] Okulich VK, Kabanova AA, Plotnikov FV. Microbial biofilms in clinical microbiology and antibacterial therapy. Vitebsk: VSMU; 2017. 300 p. (In Russ.)

[37] Klimovitskaya EG, Eshmolov SN, Sitnikov IG. Clinical, epidemiological and laboratory features of Salmonellosis in children at the present stage. Children infections. 2019;18(4):49–52. EDN: QMCYQW doi: 10.22627/2072-8107-2019-18-4-49-52

[38] Климовицкая Е.Г., Ешмолов С.Н., Ситников И.Г. Клинико-эпидемиологические и лабораторные особенности сальмонеллезов у детей на современном этапе // Детские инфекции. 2019. Т. 18, № 4. С. 49–52. EDN: QMCYQW doi: 10.22627/2072-8107-2019-18-4-49-52

[39] Klimovitskaya EG, Eshmolov SN, Sitnikov IG. Clinical, epidemiological and laboratory features of Salmonellosis in children at the present stage. Children infections. 2019;18(4):49–52. EDN: QMCYQW doi: 10.22627/2072-8107-2019-18-4-49-52

[40] Tonziello G, Valentinotti R, Arbore E, et al. Salmonella typhimurium abscess of the chest wall. Am J Case Rep. 2013;25(14):502–506. doi: 10.12659/AJCR.889546

[41] Tonziello G., Valentinotti R., Arbore E., et al. Salmonella typhimurium abscess of the chest wall // Am J Case Rep. 2013. Vol. 25, N. 14. P. 502–506. doi: 10.12659/AJCR.889546

[42] Tonziello G, Valentinotti R, Arbore E, et al. Salmonella typhimurium abscess of the chest wall. Am J Case Rep. 2013;25(14):502–506. doi: 10.12659/AJCR.889546

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