Septic Arthritis due to Salmonella Paratyphi A in a Splenectomized Thalassemia Patient.

Abstract

Salmonella bone and joint infections are unusual and account for <1% of cases of septic arthritis and osteomyelitis. We report the case of a patient with monoarticular septic arthritis with underlying beta thalassemia who had undergone splenectomy 17 years earlier. Ultrasound-guided aspiration of pus from the affected hip joint grew Salmonella Paratyphi A. The patient was started on sensitive antibiotics and responded well to treatment. Salmonella septic arthritis is more commonly observed in individuals with comorbid conditions, such as hemoglobinopathies (particularly sickle cell anemia), pre-existing joint disorders such as rheumatoid arthritis, hematologic malignancies, systemic lupus erythematosus (SLE), or other conditions associated with increased hemolysis. A limited number of cases of Salmonella septic arthritis have been reported in thalassemia patients. In typhoid endemic regions of the world, culture and susceptibility of joint fluids from septic arthritis cases can guide physicians in appropriate and timely diagnosis of this entity, especially in patients who are immunosuppressed.