Salmonella potsdam causing lumbar vertebral osteomyelitis: A case report

Abstract

Rationale: Salmonella osteomyelitis is an uncommon complication of salmonella infection, especially the salmonella vertebral osteomyelitis (SVO).

Patient concerns: We reported a case of a 29-year-old female who presented with serious lower back pain and severe limitation of motion for 50 days with no obvious inducements. She once had a fever up to 39.5°C. Physical examination only revealed limited motion of lower back without neurological complications. The laboratory results revealed no specificity. MRI of the lumbar spine revealed a spondylodiscitis at L4-L5. She underwent anterior lateral approach debridement and percutaneous posterior instrumentation.

Diagnoses: Tissue and abscess culture grew showed Salmonella Potsdam infection.

Interventions: With susceptibility testing guidance, the patient was treated with intravenous levofloxacin and ceftazidime for a period of 3 weeks and another 3-week oral antibiotics therapy.

Outcomes: The patient recovered well with no neurological deficits during the follow-up time.

Lessons: SVO is really rare and it alerts us the importance to consider uncommon pathogens in the differential diagnosis in which the etiological evidences are crucial of healthy individuals.

Figure 1

(A and B) Anterioposterior and lateral plain radiograph revealed osteoarthritic changes of the lumbar spine. There is a loss of lordosis on the lumbar spine by narrowing of the intervertebral disk space between the L4 and L5. (C and D) Magnetic resonance imaging (MRI) of the lumbar spine demonstrated spondylitis of the fourth and the fifth lumbar vertebrae, as well as destruction of intervertebral disk between them, where it is associated with paravertebral and epidural components with compression of the spinal cord. Swelling soft tissues paravertebral were also observed. (E and F) Postoperative magnetic resonance imaging (MRI) showed that abscess was drained and adjacent inflammatory tissues were removed, as well as swelling subsided. Compression of the spinal cord was relieved. (G and H) Postoperative 4 months, plain radiograph showed segmental instrumentation from L4 to L5 vertebrae. Appearances of edge sclerosis and L4/5 partly fusion were observed.