Salmonella pyomyositis with concurrent sacroiliac osteomyelitis presenting as piriformis syndrome

P, Phadke; Gandhi, Ashish; More, S. A.; Joshirao, RP

doi:10.4103/0022-3859.192799

Cited by 13 publications

(8 citation statements)

References 8 publications

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“…It usually occurs in patients with sickle-cell hemoglobinopathies, systemic lupus erythematosus, or those receiving immunosuppressive therapy [ 8 ]. Although any skeletal site can become infected, Salmonella infections of bone typically involve the long bones, chondrosternal junctions, knee, shoulder, hip, sacroiliac joints, and spine [ 9 ]. The disease usually affects immunocompetent adolescents, and the mean age of these patients in the literature is 18.8 years [ 9 ].…”

Section: Discussionmentioning

confidence: 99%

“…Although any skeletal site can become infected, Salmonella infections of bone typically involve the long bones, chondrosternal junctions, knee, shoulder, hip, sacroiliac joints, and spine [ 9 ]. The disease usually affects immunocompetent adolescents, and the mean age of these patients in the literature is 18.8 years [ 9 ]. Salmonella osteomyelitis constitutes about 0.8% of all Salmonella infections found in hospitals [ 10 ].…”

Section: Discussionmentioning

confidence: 99%

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Non-typhoidal, Non-paratyphoidal Salmonella Species Causing Sacroiliitis and Pyomyositis in a Healthy 19-Year-Old Athlete

Narala

Suhail

Leelaruban

et al. 2021

Cureus

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Salmonella is a gram-negative bacterium, subdivided into typhoidal and non-typhoidal Salmonella. It is usually caused by eating raw or undercooked meat, poultry, eggs, or egg products. The clinical manifestations of Salmonella infection can be divided into five syndromes: enterocolitis (food poisoning), enteric (typhoid) fever, bacteremia/septicemia, focal infection, and a chronic carrier state, which is usually asymptomatic. The most common clinical presentation is diarrhea. Salmonella osteomyelitis occurs most frequently in patients with sickle-cell disease; other risk factors include other hemoglobinopathies, immunocompromised status, and chronic Salmonella carrier state. The incidence of Salmonella osteomyelitis/septic arthritis in otherwise healthy individuals is rare. The duration of symptoms can range from a few months to several years, and multifocal involvement occurs in 15% of reported cases of Salmonella osteomyelitis. The symptoms of Salmonella osteomyelitis are pain and variable swelling of the affected limb; high temperatures are rarely noted. Our patient is a 19-year-old boy with no known past medical history who presented with severe right-sided sacroiliitis with extensive surrounding osteomyelitis on both sides of the sacroiliac joint with non-typhoidal, non-paratyphoidal Salmonella bacteremia.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Non-typhoidal, Non-paratyphoidal Salmonella Species Causing Sacroiliitis and Pyomyositis in a Healthy 19-Year-Old Athlete

Narala

Suhail

Leelaruban

et al. 2021

Cureus

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“…The most common isolated organism was S. aureus (57.14%), similar to our case ( Table 1 ). However, Salmonella Typhi ( 8 ), Fusobacterium necrophorum ( 9 ), Escherichia coli and Group b streptococcus ( 10 ) were also reported in some cases.…”

Section: Discussionmentioning

confidence: 99%

The piriformis abscess: a case-based review

Salehi¹,

Ghiasvand²,

Feizabadi³

et al. 2021

IJM

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This study reports a 43 years-old man diagnosed with piriformis pyomyositis. A literature review was conducted by searching MEDLINE via Pubmed for English language case reports, published from 8 th December 2019 to 20th January 2020. Patients' symptoms, laboratory tests, imaging, treatment, and other comorbidities were evaluated. Thirty-two cases diagnosed with piriformis pyomyositis, of which 21 patients developed piriformis abscess (including one new patient added by us) of which 52.4% were female, and the mean age was 26.98 ± 17.5. The most common manifestations were fever, lower back pain, and limited ambulation with increased ESR, CRP, or leukocytosis. Staphylococcus aureus was the most prevalent (57.14%) pathogen isolated. The authors suggested gynecologic manipulations, muscle overuse, and other co-infections as probable risk factors. However, we fail to find any association between these factors and abscess formation (p>0.05). Piriformis abscess should be regarded as a probable diagnosis in patients with gluteal pain, fever, and limited ambulation that have raised inflammatory markers or leukocytosis. MRI and CT scans are beneficial in diagnosing pyomyositis in early-stage. Full recovery is expected with timely antibiotic and surgical treatments.

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“…Diabetes mellitus, HIV infection, alcoholism, cancer chemotherapy, steroid use, and trauma are common predisposing factors for pyomyositis. [324] S. typhi -related pyomyositis has been described in an immunocompetent male from India. [24] Naidoo et al ., described four people with typhoid polymyositis, with three from the same family and suggested a genetic predisposition.…”

Section: Discussionmentioning

confidence: 99%

“…[324] S. typhi -related pyomyositis has been described in an immunocompetent male from India. [24] Naidoo et al ., described four people with typhoid polymyositis, with three from the same family and suggested a genetic predisposition. [25] Other focal extraintestinal abscesses arising due to S paratyphi infections such as the breast and kidneys have also been reported, all of them being in young adults.…”

Section: Discussionmentioning

confidence: 99%

Myositis associated with Salmonella paratyphi A bacteremia appears to be common

Harris

Viswanathan

Aghoram

2019

J Family Med Prim Care

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Background: Fever and severe myalgia in a tropical country like India bring to mind leptospirosis, rickettsioses, dengue, and other viral fevers. Enteric fever is widely prevalent in Asia, but myositis has not been previously described in Salmonella paratyphi A bacteremia. Materials and Methods: Retrospectively, we recruited patients with enteric fever admitted to our treating unit over a 6-month period. Demography, historical, clinical, and laboratory data were obtained. Data of culture-positive S. paratyphi A patients were analyzed and were compared with those patients with culture-negative enteric fever. Results: Forty-three cases were found in total with 19 of S. paratyphi A bacteremia. Elevations in creatine kinase (CK) ranged from one-and-half to six times normal. Forty-seven percent had thrombocytopenia and alanine transaminase elevations, while aspartate transaminase elevations were seen in 17 patients, which corresponded to those with elevated CK levels. Conclusions: Myositis associated with S. typhi and S. paratyphi is very rare and is more often due to non-typhoidal Salmonellae. Elevated creatine kinase was seen in most of our patients with S. paratyphi A bacteremia. Such myositis has not been described previously and hence, myalgia with fever in a tropical country could be a harbinger of paratyphoid fever.

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Salmonella pyomyositis with concurrent sacroiliac osteomyelitis presenting as piriformis syndrome

Cited by 13 publications

References 8 publications

Non-typhoidal, Non-paratyphoidal Salmonella Species Causing Sacroiliitis and Pyomyositis in a Healthy 19-Year-Old Athlete

Non-typhoidal, Non-paratyphoidal Salmonella Species Causing Sacroiliitis and Pyomyositis in a Healthy 19-Year-Old Athlete

The piriformis abscess: a case-based review

Myositis associated with Salmonella paratyphi A bacteremia appears to be common

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