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Salmonella enteritidis osteomyelitis of the tibia--a case report and review of literature on Salmonella osteomyelitis of Japanese patients

机译：胫骨沙门氏菌肠炎骨髓炎 - 一种日本患者沙门氏菌骨髓炎文学案例报告与综述

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摘要

We described a rare case of Salmonella enteritidis osteomyelitis of the tibia combined with arthritis of the ankle joint. A 4-year-old, otherwise healthy girl was hospitalized with 9-day history of fever, left leg pain, and diarrhea. On admission, her left lower leg and ankle were markedly reddened and swollen. Laboratory examinations disclosed a WBC of 16,300/microliter and a C-reactive protein of 15.6 mg/dl. A T2-weighed magnetic resonance image of the leg depicted a high intensity area around the left distal tibia and an extremely high intensity fluid in her left ankle joint, leading to our diagnosis of purulent osteomyelitis of the tibia and arthritis of the ankle joint. Salmonella enteritidis was isolated from ankle joint fluid and later aspirated bone marrow of the tibia, but not from blood or stool. Because of poor response to intravenous treatment with panipenem/betamipron for 2 days, she underwent drainage and washing of the joint fluid, and intramedullary administration of cefotaxime and ampicillin. She completely recovered without sequelae following treatment with sensitive antibiotics for 4 weeks in total. There has not been any relapse for more than 1.5 years. The authors also bibliographically surveyed the literature published from 1966 to 2002 and found 35 Japanese patients with Salmonella osteomyelitis. The present patient was the second case caused by Salmonella enteritidis in Japan. Septic arthritis is a rare complication, accounting for only 8% of the patients. Since Salmonella enteritidis has been a leading serotype among human isolates of Salmonella species during the past decade, it would be warranted to determine whether osteomyelitis due to this organism is likely to increase.
机译：我们描述了胫骨沙门氏菌肠炎骨髓炎的罕见案例与踝关节的关节炎相结合。一个4岁的，否则健康的女孩被住院治疗了9天的发烧，左腿疼痛和腹泻。在入场时，她的左下腿和脚踝显着变红，肿胀。实验室检查公开了WBC，16,300 / microLIER和15.6mg / dl的C反应蛋白。腿部的T2称重磁共振图像描绘了左侧远端胫骨周围的高强度区域和她左侧踝关节的极高强度流体，导致我们对胫骨和踝关节关节炎的脓性骨髓炎的诊断。 Salmonella肠炎虫是从踝关节液和后来的胫骨吸气骨髓中分离出来的，但不是来自血液或粪便。由于对胰岛素/伯爵普伦的静脉内治疗较差2天，她接受了对关节液的引流和洗涤，以及髓内施用头孢噻肟和氨苄青霉素。在用敏感的抗生素治疗总共4周后，她完全恢复了后遗症。超过1.5年的复​​发没有任何复发。作者还从1966年到2002年发布的文献中的书目调查，发现了35例日本沙门氏菌骨髓炎患者。目前患者是日本沙门氏菌肠炎虫引起的第二种病例。化脓性关节炎是一种罕见的并发症，仅占8％的患者。由于在过去十年中，Salmonella Enteritidis是Salmonella物种的人类分离株的主要血清型，因此有必要确定由于这种有机体引起的骨髓炎是否可能增加。

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