Salmonella Osteomyelitis and Septic Arthritis in Children

Abstract

Salmonella infections of the bone and joints are very rare. They are common in hemoglobinopathies and immunocompromised children. The diaphysis and metaphysis of the long bones are common sites. The spine pelvis, ribs, and cranium are rare sites. The clinical course is indolent compared to acute osteomyelitis. Serological tests and culture can be used for the diagnosis. Radiographs are frequently negative early in the disease. CT scans and MRI scans can be used in certain cases. The majority of cases can be managed with antibiotics. In this review, we describe the etiology, clinical features, investigations, and management of Salmonella bone and joint infections. We have described the features of Salmonella bone and joint infections in normal and sickle disease patients. We also present an illustrative case of Salmonella septic arthritis of the shoulder in an immunocompetent infant one month after COVID-19 infection.

Acute haematogenous osteomyelitis in the paediatric population: a current concepts review

“…82 The incidence increases to between 1.5% and 12% in children with sickle cell disease. 83 It is interesting to note that a prior review article by Burnett et al in 1998 indicated a higher ratio (1.4:1) of Salmonella AHOM compared to S. aureus in patients with sickle cell disease. 84 This ratio was even lower than a report from 1981, which reported that 50 out of 68 positive cultures yielded Salmonella.…”

“…86 However, Salmonella osteomyelitis has been reported as typically affecting the diaphysis of long bones, particularly the femur and humerus, as well as the vertebrae. 82,83…”