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Vertebral Osteomyelitis due to Salmonella

Salmonella Osteomyelitis of Head Neck or Trunk


Presentation

  • Diabetes mellitus was present in 3 cases. Only one case presented with neurological deficit. The duration of symptoms before diagnosis ranged from 15 days to 12 years.[journals.lww.com]
  • Prepared by internationally recognized members of The Cervical Spine Research Society Editorial Committee, the Fifth Edition presents new information, new technologies, and advances in clinical decision making.[books.google.com]
  • Grasp and apply the latest knowledge from more than 25 brand-new chapters, as well as extensive revisions or total rewrites to the majority of existing chapters to present all of the most up-to-date information available on every aspect of spine surgery[books.google.de]
  • The patient initially presented with abdominal, urinary and chest symptoms, which were followed by a large pleural effusion. The infection was successfully treated with ciprofloxacin.[ncbi.nlm.nih.gov]
  • Vertebral osteomyelitis presenting with bilateral pleural effusion in a leprous patient. Diagn Microbiol Infect Dis 1996 ; 24 : 101 –3. Carr AJ , Crow PG. Vertebral osteomyelitis presenting with abdominal pain and pleural effusion.[pmj.bmj.com]
Fever
  • A 53-year-old man was referred to the outpatient department of a tertiary care center with a 4-month history of low back pain accompanied by fever.[journals.lww.com]
  • It is therefore important to consider uncommon pathogens in the differential diagnosis of travellers with prolonged fever and insidious symptoms.[ncbi.nlm.nih.gov]
  • In the review by Santos and Sapico, fever and back pain were the main complaints in patients with Salmonella vertebral osteomyelitis, with fever present in 87% of cases and back pain 92% [5].[ijcasereportsandimages.com]
  • In adults, back pain is typically the chief complaint but once the infection becomes systemic, a low-grade fever may be present.[physio-pedia.com]
  • The clinical features of Salmonella infection are usually acute in onset with high fever, chills, severe bone pains, leucocytosis and raised ESR, [7] however they may have insidious onset.[neurologyindia.com]
Malaise
  • […] features Acute osteomyelitis Onset : usually gradual, over several days Chief complaint : pain at the site of infection, possibly related to movement Possible localized findings : point tenderness, swelling, redness, warmth Possible systemic findings : malaise[amboss.com]
  • They will usually have chills, fever and malaise. There is usually pain and localized swelling and redness over the site of infection in the bone and guarding of the body part.[atsu.edu]
  • When the infection extends into the periosteum of the bone, individuals may experience joint pain, decreased function, and systemic signs, such as fever, swelling, and malaise [1].[physio-pedia.com]
Malnutrition
  • (serum albumin 3 g/dL indicative of malnutrition) trauma smoking Pathophysiology pathogens staph aureus most common (50-65%) staph epidermidis is second most common cause gram negative infections increasing over last decade and often associated with[orthobullets.com]
  • Systemic Involvement There are several systemic factors that affect immune surveillance, metabolism, and local vascularity that may lead to an increased risk for developing osteomyelitis [8] : Malnutrition Renal or hepatic failure Diabetes mellitus Chronic[physio-pedia.com]
  • Physiologic class A host: healthy B host: Bs: systemic compromise Bl: local compromise Bls: local and systemic compromise C host: treatment worse than the disease Factors affecting immune surveillance, metabolism and local vascularity Systemic factors (Bs): malnutrition[aafp.org]
Malaise
  • […] features Acute osteomyelitis Onset : usually gradual, over several days Chief complaint : pain at the site of infection, possibly related to movement Possible localized findings : point tenderness, swelling, redness, warmth Possible systemic findings : malaise[amboss.com]
  • They will usually have chills, fever and malaise. There is usually pain and localized swelling and redness over the site of infection in the bone and guarding of the body part.[atsu.edu]
  • When the infection extends into the periosteum of the bone, individuals may experience joint pain, decreased function, and systemic signs, such as fever, swelling, and malaise [1].[physio-pedia.com]
Splenomegaly
  • There was no hepato-splenomegaly. Local examination of the spine revealed that para-vertebral muscles were in spasm and lumbar lordosis was obliterated tenderness over spinous process of L1 and L2, no obvious swelling, no motor or sensory deficit.[neurologyindia.com]
  • CT Abdomen demonstrated hepatomegaly and splenomegaly but no focal abnormality. The colon was dilated to the level of the splenic flexure with calibre change at this level.[ncbi.nlm.nih.gov]
Aspiration
  • The key to diagnosis is bacterial culture of aspirated specimen. Salmonella and tuberculous spondylitis must be differentiated because both have similar epidemiological and clinicoradiologic presentations.[journals.lww.com]
  • A needle aspiration of the abscess grew Salmonella enteritidis phage type 2 .[pmj.bmj.com]
  • Fluoroscopy or computed tomography guided needle aspiration with subsequent culture should be performed for definitive diagnosis.[ijcasereportsandimages.com]
  • We feel minimal invasive techniques like CT guided Fine needle Aspiration or percutaneous transpedicular Craig biopsy needles can be used to obtain tissue diagnosis. » References 1. Givner LB, Luddy RE. Shwartz AD.[neurologyindia.com]
  • […] osteomyelitis Initial work-up: see flowchart Contrast-enhanced MRI : the most sensitive diagnostic study ; for vertebral osteomyelitis Gallium bone scan if MRI is contraindicated (metal foreign body implants) detects sites of infection CT -guided needle aspiration[amboss.com]
Pleural Effusion
  • The patient initially presented with abdominal, urinary and chest symptoms, which were followed by a large pleural effusion. The infection was successfully treated with ciprofloxacin.[ncbi.nlm.nih.gov]
  • Figure 1 Chest radiograph showing right sided pleural effusion.[pmj.bmj.com]
  • Osteomyelitis of thoracic spine should be considered in the differential diagnosis of pleural effusion.[jocr.co.in]
Pertussis
  • […] delivery, and in the neonatal period Stay on the cutting edge of your field with new and improved chapters including: obstetric factors associated with infections of the fetus and newborn infant; human milk; borella infections; tuberculosis; bordetella pertussis[books.google.de]
Diarrhea
  • None of the cases had diarrhea or abdominal discomfort. The erythrocyte sedimentation rate was elevated consistently. Stool and blood cultures were positive in 1 and 2 cases, respectively. The Widal test was positive in 13 cases.[journals.lww.com]
  • This is rare but serious. ...Read more Salmonella (Definition) Is a bacterium which is a cause of gastrointestinal infection presenting with fever and diarrhea for 4-7 days and is transmitted as a zoonosis, that is, directly or indirectly from an animal[healthtap.com]
  • The patient denied any recent trauma, weight loss, nausea, vomiting or diarrhea, or urinary symptoms. He also denied consumption of unpasteurized milk or undercooked poultry. Patient denies recently interacting with any known sick contacts.[ijcasereportsandimages.com]
  • Volume 25, Issue 2 28 Salmonella senftenberg : Ear infection - a case report Bairy Indira, Bhaskaranand Nalini, Shivananda P G Indian Journal of Medical Sciences , Year 2000, Volume 54, Issue 2 29 Salmonella enterica serotype paratyphi a induced acute diarrhea[ijccm.org]
  • Volume 3, Issue 4 28 Salmonella senftenberg : Ear infection - a case report Bairy Indira, Bhaskaranand Nalini, Shivananda P G Indian Journal of Medical Sciences, Year 2000, Volume 54, Issue 2 29 Salmonella enterica serotype paratyphi a induced acute diarrhea[indianjcancer.com]
Abdominal Pain
  • Other symptoms can include: changes in your posture stiffness in your back difficulty performing regular mobility tasks abdominal pain or discomfort fever Viral or bacterial infections can cause discitis. An autoimmune disorder can also cause it.[healthline.com]
  • Right upper abdominal pain, weight loss, anorexia and left leg swelling were also present. There was no history of trauma and no significant past medical history of note.[ncbi.nlm.nih.gov]
  • Approximately one month later in September, 1977 the patient presented at another institution complaining of the aCute onset of nausea, vomiting and abdominal pain.[healio.com]
  • Vertebral osteomyelitis presenting with abdominal pain and pleural effusion. J R Coll Surg Edinb 1987 ; 32 : 373 –4. Sullivan PJ , Currie D, Collins JV, et al.[pmj.bmj.com]
Abdominal Pain
  • Other symptoms can include: changes in your posture stiffness in your back difficulty performing regular mobility tasks abdominal pain or discomfort fever Viral or bacterial infections can cause discitis. An autoimmune disorder can also cause it.[healthline.com]
  • Right upper abdominal pain, weight loss, anorexia and left leg swelling were also present. There was no history of trauma and no significant past medical history of note.[ncbi.nlm.nih.gov]
  • Approximately one month later in September, 1977 the patient presented at another institution complaining of the aCute onset of nausea, vomiting and abdominal pain.[healio.com]
  • Vertebral osteomyelitis presenting with abdominal pain and pleural effusion. J R Coll Surg Edinb 1987 ; 32 : 373 –4. Sullivan PJ , Currie D, Collins JV, et al.[pmj.bmj.com]
Back Pain
  • A 53-year-old man was referred to the outpatient department of a tertiary care center with a 4-month history of low back pain accompanied by fever.[journals.lww.com]
  • pain and psychosocial interactions, biomechanics, and more.[books.google.de]
  • On presentation, she reported 18 months of severe low back pain that started after a scuba diving trip.[readbyqxmd.com]
  • In the review by Santos and Sapico, fever and back pain were the main complaints in patients with Salmonella vertebral osteomyelitis, with fever present in 87% of cases and back pain 92% [5].[ijcasereportsandimages.com]
  • pain were the main symptoms on presentation in 44 cases of vertebral osteomyelitis that they reviewed. 6 Thus one should suspect vertebral osteomyelitis in a patient with fever and back pain, and in particular salmonella infection should be considered[ncbi.nlm.nih.gov]
Back Pain
  • A 53-year-old man was referred to the outpatient department of a tertiary care center with a 4-month history of low back pain accompanied by fever.[journals.lww.com]
  • pain and psychosocial interactions, biomechanics, and more.[books.google.de]
  • On presentation, she reported 18 months of severe low back pain that started after a scuba diving trip.[readbyqxmd.com]
  • In the review by Santos and Sapico, fever and back pain were the main complaints in patients with Salmonella vertebral osteomyelitis, with fever present in 87% of cases and back pain 92% [5].[ijcasereportsandimages.com]
  • pain were the main symptoms on presentation in 44 cases of vertebral osteomyelitis that they reviewed. 6 Thus one should suspect vertebral osteomyelitis in a patient with fever and back pain, and in particular salmonella infection should be considered[ncbi.nlm.nih.gov]
Low Back Pain
  • A 53-year-old man was referred to the outpatient department of a tertiary care center with a 4-month history of low back pain accompanied by fever.[journals.lww.com]
  • On presentation, she reported 18 months of severe low back pain that started after a scuba diving trip.[readbyqxmd.com]
  • back pain for 1 week duration.[orthobullets.com]
  • Discussion This patient gave a history of improperly treated enteric fever, six months prior to admission with low back pain.[ijmm.org]
  • A 42-year-old man experienced low-back pain and fever for 5 days.[ajnr.org]
Paravertebral Muscle Spasm
  • There was tenderness on palpation along the lumbar spine posteriorly, associated with paravertebral muscle spasms. There were no neurological finding.[jstage.jst.go.jp]
Myelopathy
  • […] pain pain is often severe and insidious in onset pain is usually worse with activity and unrelenting in nature pain that awakens patients at night should raise concern for malignancy and infection neurologic symptoms present in 10-20% radiculopathy myelopathy[orthobullets.com]

Workup

  • 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.[readbyqxmd.com]
Salmonella Typhi
  • We did a Medline search of the English-language literature on Salmonella typhi vertebral osteomyelitis and reviewed reference lists for additional cases published since the year 1900. Our search yielded only 19 cases.[journals.lww.com]
  • Pancreatic abscess caused by Salmonella typhi. Indian J Med Microbiol 2001;19(2):103-104. 4. Jayakumar K, Appalaraju B, Govindan VK. An Atypical presentation of Salmonella typhi - A Case Report. Indian J Med Microbiol 2003;21(3):211-212. 5.[ijmm.org]
  • typhi and other Salmonellae i...[ijccm.org]
  • Lakshmi K, Santhanam R Journal of Neurosciences in Rural Practice, Year 2016, Volume 7, Issue 2 44 Detection of Salmonella typhi 'O' antigen by counter-immuno-electrophoresis.[indianjcancer.com]
  • Only salmonella typhi is ...Read more Osteomyelitis (Bone Infection) (Definition) An infection of the bone where bacteria invade the bone and bone marrow. ...Read more[healthtap.com]
Bordetella Pertussis
  • pertussis and other bordetella sp infections; herpes simplex; toxoplasmosis; pneumocystis and other less common fungal infections; and healthcare-associated infections in the nursery Keep up with the most relevant topics in fetal/neonatal infectious[books.google.de]
Pleural Effusion
  • The patient initially presented with abdominal, urinary and chest symptoms, which were followed by a large pleural effusion. The infection was successfully treated with ciprofloxacin.[ncbi.nlm.nih.gov]
  • Figure 1 Chest radiograph showing right sided pleural effusion.[pmj.bmj.com]
  • Osteomyelitis of thoracic spine should be considered in the differential diagnosis of pleural effusion.[jocr.co.in]

Treatment

  • Form a definitive diagnosis and create the best treatment plans possible using evidence-based recommendations and expert guidance from world authorities.[books.google.de]
  • The text provides state-of-the-art coverage of basic and clinical research, diagnostic methods, and medical and surgical treatments, bringing together the latest thinking of the foremost orthopaedic surgeons, neurosurgeons, neurologists, rheumatologists[books.google.com]
  • Treatment of tuberculosis and tuberculosis infection in adults and children. American Thoracic Society and the Centers for Disease Control and Prevention. ‎[books.google.de]
  • Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization[books.google.de]
  • Standard treatment with ampicillin and trimethoprim-sulfamethoxazole failed to cure the infection. She recovered after a course of moxalactam therapy and surgery.[ncbi.nlm.nih.gov]

Prognosis

  • […] surgical debridement of necrotic bone, weakened host defenses May develop sinus tract lined by squamous epithelium that forms large epidermal inclusion cyst within bone; rarely transforms to well differentiated squamous cell carcinoma with excellent prognosis[pathologyoutlines.com]
  • Prognosis Prognosis varies depending on how quickly an infection is identified, and what other underlying conditions exist to complicate the infection.[medical-dictionary.thefreedictionary.com]
  • Treatment and prognosis Treatment is typically with intravenous antibiotics, usually for extended periods. If a collection, sequestrum or involucrum is present then drainage and/or surgical debridement is often necessary.[radiopaedia.org]
  • Incidence and prognosis of non-typhoid Salmonella bacteraemia in Denmark: a 10-year county-based follow-up study. European Journal of Clinical Microbiology & Infectious Diseases 2006 ; 25 : 151 – 158. 29. Gordon, MA.[cambridge.org]

Etiology

  • Etiology The specific microorganism(s) isolated from patients with bacterial osteomyelitis is often associated with the age of the patient or the clinical scenario ( Tables 5 15 and 6 16 ).[aafp.org]
  • OBJECTIVES: To define the magnetic resonance imaging characteristics of infections of the spine in acute and chronic stages and to evaluate the role of magnetic resonance imaging in defining their etiology.[readbyqxmd.com]
  • Etiology of osteomyelitis in patients with major sickle hemoglobinopathies. J Pediatric 1981;99;411-3. 2. Ortiz-Neu C, Marr JS, Cherrbin CE, Neu HS. Bone and joint infections due to Salmonella. J infect Dis 1978;138;820-8. 3. Murphy JB.[neurologyindia.com]
  • Etiology Routes of infection Hematogenous osteomyelitis : most commonly due to a single pathogen Exogenous osteomyelitis : usually due to multiple pathogens Posttraumatic: infection following deep injury (penetrating injury, open fractures, severe soft[amboss.com]
  • Etiology of osteomyelitis in patient with major sickle haemoglobinopathies. J Pediatr 1981 ; 99 : 411 –13. Brayton RG , Stoles PE, Schwartz MS, et al.[pmj.bmj.com]

Epidemiology

  • Epidemiology of severe sepsis in the United States: analysis of incidence, outcome, and associated costs of care. ‎[books.google.de]
  • Salmonella and tuberculous spondylitis must be differentiated because both have similar epidemiological and clinicoradiologic presentations. The emergence of nalidixic acid resistance is associated with fluoroquinolone therapeutic failures.[journals.lww.com]
  • ISSN: 0950-2688 EISSN: 1469-4409 URL: /core/journals/epidemiology-and-infection[cambridge.org]
  • : more common in adults References: [1] [2] [3] [4] Epidemiological data refers to the US, unless otherwise specified.[amboss.com]
  • Introduction Vertebral osteomyelitis, also known as spondylodiskitis Epidemiology demographics usually seen in adults (median age for pyogenic osteomyelitis is 50 to 60 years) location 50-60% of cases occur in lumbar spine 30-40% in thoracic spine 10%[orthobullets.com]
Sex distribution
Age distribution

Pathophysiology

  • References: [4] Subtypes and variants Definition : osteomyelitis of the vertebrae Pathophysiology : hematogenous seeding of a distant infectious focus infection of the vertebral bone contiguous spread to the intervertebral discs (and adjacent vertebrae[amboss.com]
  • Brodie abscess : Small intraosseous abscess in cortex, walled off by reactive bone with no periosteal reaction Cavity may contain infectious organisms or be sterile May have late recrudescence Therapy: total surgical excision ( Tunis Med 2007;85:857 ) Pathophysiology[pathologyoutlines.com]
  • The pathophysiology of osteomyelitis is complex and poorly understood.[physio-pedia.com]
  • The accepted explanation of the underlying pathophysiology involves intravascular sickling of the bowel leading to ischemic infarction and development of vulnerable areas in the bowel for bacterial entry.[ijcasereportsandimages.com]
  • […] cervical spine risk factors include IV drug abuse diabetes recent systemic infection (UTI, pneumonia) obesity malignancy immunodeficiency or immunosuppressive medications malnutrition (serum albumin 3 g/dL indicative of malnutrition) trauma smoking Pathophysiology[orthobullets.com]

Prevention

  • Seite 476 - Prevention of hepatitis A through active or passive immunization: recommendations of the Advisory Committee on Immunization Practices (ACIP). ‎[books.google.de]
  • Special attention is given to the prevention and treatment of these diseases found in developing countries as well as the latest findings about new antimicrobial agents, gram-negative infections and their management, and recommendations for immunization[books.google.de]
  • Prevention is another area in cases of osteomyelitis where physical therapists can play an important role.[physio-pedia.com]
  • Objective To investigate etiopathogenesis, early diagnosis and prevention and cure of chronic osteomyelitis after phalange wound. 27.[sentencedict.com]

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