Osteoarticular Salmonella infections in healthy children

Abstract

Introduction: Osteoarticular infections caused by Salmonella spp. are rare. Salmonella osteomyelitis is more common in children with underlying chronic diseases or immunodeficiency, but is rare in previously healthy children. Patient concerns: Six previously healthy children with Salmonella osteoarticular infections were admitted to our hospital. Identification and characterization of the isolates were also performed and correlated with the clinical findings. Diagnosis: The predominant symptoms were fever, pain, and swelling. Three patients were diagnosed with osteomyelitis (including 2 with left humerus, 1 with left tibia), 1 patient with osteoarthritis (elbow, right), and 2 patients with septic arthritis (knee joint, right). Interventions: Surgical drainage was performed in all children, and the aspirates were subsequently cultured. Intravenous antibiotic therapy combined with surgical drainage of purulent material is necessary to eradicate the infection. Outcomes: A 2-year follow-up showed good healing in all six children after clinical interventions. Conclusion: Osteoarticular infections caused by Salmonella have no distinctive features, clinical manifestations, or radiological characteristics. Intravenous antibiotics combined with surgical debridement/drainage are necessary for eradication of the bacteria.