Salmonella potsdam causing lumbar vertebral osteomyelitis: A case report

Medicine (Baltimore). 2018 May;97(18):e0682. doi: 10.1097/MD.0000000000010682.

Abstract

Rationale: Salmonella osteomyelitis is an uncommon complication of salmonella infection, especially the salmonella vertebral osteomyelitis (SVO).

Patient concerns: We reported a case of a 29-year-old female who presented with serious lower back pain and severe limitation of motion for 50 days with no obvious inducements. She once had a fever up to 39.5°C. Physical examination only revealed limited motion of lower back without neurological complications. The laboratory results revealed no specificity. MRI of the lumbar spine revealed a spondylodiscitis at L4-L5. She underwent anterior lateral approach debridement and percutaneous posterior instrumentation.

Diagnoses: Tissue and abscess culture grew showed Salmonella Potsdam infection.

Interventions: With susceptibility testing guidance, the patient was treated with intravenous levofloxacin and ceftazidime for a period of 3 weeks and another 3-week oral antibiotics therapy.

Outcomes: The patient recovered well with no neurological deficits during the follow-up time.

Lessons: SVO is really rare and it alerts us the importance to consider uncommon pathogens in the differential diagnosis in which the etiological evidences are crucial of healthy individuals.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / administration & dosage
  • Ceftazidime / administration & dosage*
  • Debridement / methods*
  • Discitis* / diagnosis
  • Discitis* / microbiology
  • Discitis* / physiopathology
  • Discitis* / therapy
  • Female
  • Humans
  • Levofloxacin / administration & dosage*
  • Lumbar Vertebrae* / diagnostic imaging
  • Lumbar Vertebrae* / pathology
  • Magnetic Resonance Imaging / methods
  • Microbial Sensitivity Tests / methods
  • Neurologic Examination / methods
  • Orthopedic Procedures / methods
  • Osteomyelitis* / diagnosis
  • Osteomyelitis* / microbiology
  • Osteomyelitis* / physiopathology
  • Osteomyelitis* / therapy
  • Range of Motion, Articular
  • Salmonella enterica* / drug effects
  • Salmonella enterica* / isolation & purification
  • Salmonella enterica* / pathogenicity
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Levofloxacin
  • Ceftazidime