Typhoid spondylodiscitis mimicking tuberculosis in a teenage girl

Abstract

Salmonella Typhi cause a broad spectrum of human illnesses like gastroenteritis, typhoid fever, and bacteremia. It has also been recognized as a causative organism of osteomyelitis for more than a century but the incidence appears to be uncommon. Microbiological workup plays important role in the diagnosis of Typhoid spondylodiscitis as most of the time it mimics tuberculosis and misguide the clinician, especially in the developing world. Here, we reported an uncommon case of lumbar spondylodiscitis by Salmonella Typhi in an immunocompetent teenager, with the help of clinical, microbiological and radiological evidence. The case was managed conservatively after posterior spinal stabilization.

SalmonellaTyphi dorsolumbar spondylodiscitis mimicking tuberculosis – An interesting case report

“…[6] However, the key to absolute diagnosis is the recovery of the organism, which can usually come from bone or pus specimens and blood cultures. [1,6] Once Salmonella infection is identified, it usually responds to treatment with antibiotics such as chloramphenicol, ciprofloxacin, levofloxacin, ceftriaxone, or ampicillin. [1,6] e duration of antibiotic treatment is varying from 6 weeks, 8 weeks, to 9 weeks.…”

“…[1,6] Once Salmonella infection is identified, it usually responds to treatment with antibiotics such as chloramphenicol, ciprofloxacin, levofloxacin, ceftriaxone, or ampicillin. [1,6] e duration of antibiotic treatment is varying from 6 weeks, 8 weeks, to 9 weeks. [6] However, evidence of multidrugresistant enteric pathogens is rising.…”

“…[ 6 ] However, the key to absolute diagnosis is the recovery of the organism, which can usually come from bone or pus specimens and blood cultures. [ 1 , 6 ]…”

Salmonella osteomyelitis: A rare extraintestinal manifestation of an endemic pathogen

“…Insignificant Widal test results in the same case which could possibly be due to early and inadvertent administration of antibiotics (although a clear-cut past medical and treatment history was not available) and waning humoral immune response. [7,8,[14][15][16][17][18][19][20][21][22][23][24] In all the three cases we are reporting, Salmonella osteomyelitis was not initially suspected, and no identifiable risk factors were noted. Since this entity is clinically as well as radiographically similar to osteomyelitis caused by other pyogenic agents, it is essential to diagnose and treat such cases accordingly.…”

An adolescent with multi-organ involvement from typhoid fever

“…Bone and joint complications in typhoid include osteomyelitis and septic arthritis. A case has also been reported in which a patient developed pyogenic spondylodiscitis with typhoid infection that mimicked spinal tuberculosis 7…”