Nontyphoidal Salmonella Osteomyelitis in Immunocompetent Children Without Hemoglobinopathies

Abstract

Salmonella osteomyelitis is well-described in children with hemoglobinopathies, particularly infection with Salmonella typhi. To characterize nontyphoidal osteomyelitis in otherwise healthy children without hemoglobinopathies, we performed a retrospective review of children discharged from our institution with this condition, supplemented with a systematic literature review. Among the 46 subjects identified, common risk factors for Salmonella infection were frequently absent and complications were common.

MetatarsalSalmonella enteritidisosteomyelitis in a healthy child

“…Salmonella osteomyelitis is more common in children with SCD, primary immunodeficiencies (defects of the IL-2/IFN-γ axis) and acquired immunodeficiencies (HIV, malignancy, immunosuppressive therapy) 4–7 9–11. In otherwise healthy children, it is very rarely reported 4–9. A recent review shows 46 cases of osteomyelitis due to NTS in children without a known immunodeficiency or SCD between 1960 and 2016 7.…”

“…In otherwise healthy children, it is very rarely reported 4–9. A recent review shows 46 cases of osteomyelitis due to NTS in children without a known immunodeficiency or SCD between 1960 and 2016 7. The most commonly affected bones are the humerus and vertebrae, followed by the tibia and pelvis 4 7.…”

“…A recent review shows 46 cases of osteomyelitis due to NTS in children without a known immunodeficiency or SCD between 1960 and 2016 7. The most commonly affected bones are the humerus and vertebrae, followed by the tibia and pelvis 4 7. The metatarsals have been extremely rarely implicated in Salmonella osteomyelitis 12.…”

“…Most cases of Salmonella osteomyelitis occur in individuals with immunodeficiencies or haemoglobinopathies, mainly sickle cell disease (SCD), but are very rare in healthy children 4–9. Non-typhoidal Salmonella (NTS) strains are the most commonly implicated, namely Salmonella enteritidis , Salmonella typhimurium and Salmonella paratyphi B 7 8 . Salmonella enteritidis is responsible for up to 85% of cases of NTS bacteraemia in children 7…”

“…Non-typhoidal Salmonella (NTS) strains are the most commonly implicated, namely Salmonella enteritidis , Salmonella typhimurium and Salmonella paratyphi B 7 8 . Salmonella enteritidis is responsible for up to 85% of cases of NTS bacteraemia in children 7…”