Nalidixic acid-resistant Salmonella enterica serotype Typhi presenting as a primary psoas abscess: case report and review of the literature

Abstract

We report an unusual case of Salmonella enterica serotype Typhi presenting as a primary psoas abscess. The isolate tested susceptible to ciprofloxacin but resistant to nalidixic acid in vitro, a pattern associated with fluoroquinolone therapeutic failures. We review the literature for serovar Typhi psoas abscess in the absence of bacteremia and discuss the importance of identifying isolates with reduced susceptibility to fluoroquinolones.

FIG. 1.

Computed tomography image demonstrating enlargement of the left psoas muscle with increased density suggestive of abscess. Surrounding inflammatory change and fat stranding are also present. All inguinal lymph nodes are less than 1 cm in diameter.