Salmonella osteomyelitis of multiple ribs and thoracic vertebra with large psoas muscle abscesses

Spine J. 2009 Nov;9(11):e1-4. doi: 10.1016/j.spinee.2009.06.013. Epub 2009 Aug 5.

Abstract

Background context: Salmonella vertebral osteomyelitis is a well-known complication of sickle cell disease. However, it has been infrequently reported in immunologically normal people or diabetic patients.

Purpose: To report a case of Salmonella vertebral osteomyelitis in a diabetic patient with multiple rib infections, large bilateral psoas muscle abscesses, and pleural effusion.

Study design/setting: Case report.

Methods: A case of Salmonella vertebral osteomyelitis is reported in a 42-year-old man with diabetes. The patient had multiple rib and T12 vertebral infections with pleural effusion and large bilateral psoas muscle abscesses. The adjacent discs were intact.

Results: Diagnosis was made by computed tomography-guided psoas muscle abscess drainage and aspirate culture. Appropriate antibiotic treatment resulted in a favorable outcome. The patient had mild back pain with a 38 degrees residual kyphosis at his thoracolumbar junction after treatment.

Conclusions: Vertebral osteomyelitis caused by Salmonella is uncommon in diabetic patients. Salmonella can cause multiple bone infections and large abscesses of psoas muscles in patients without sickle cell disease. Correct diagnosis can be confirmed by blood, biopsy, or abscess culture. Appropriate antibiotic treatment was effective.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Anti-Bacterial Agents / therapeutic use
  • Diabetes Complications / drug therapy
  • Drainage
  • Humans
  • Male
  • Osteomyelitis / microbiology
  • Osteomyelitis / pathology*
  • Osteomyelitis / therapy
  • Pleural Effusion / drug therapy
  • Pleural Effusion / microbiology
  • Pleural Effusion / pathology
  • Psoas Abscess / microbiology
  • Psoas Abscess / pathology*
  • Psoas Abscess / therapy
  • Ribs / microbiology
  • Ribs / pathology*
  • Salmonella Infections / complications*
  • Salmonella Infections / pathology
  • Salmonella Infections / therapy
  • Thoracic Vertebrae / microbiology
  • Thoracic Vertebrae / pathology*

Substances

  • Anti-Bacterial Agents