Salmonellosis osteomyelitis of the pelvic bones in adolescent: a case report

Salmonellosis osteomyelitis is a rare form of extraintestinal salmonellosis in children that occurs against the background of sepsis. This article presents observation of salmonellosis osteomyelitis in a previously healthy 17-year-old patient. The patient experienced pain in the right lower limb with restriction of its mobility. Magnetic resonance imaging revealed bone-destructive changes in the lumbosacral spine. Thrombocytopenia progressed to 60×109/l. In the oncohematologic domain, secondary character of thrombocytopenia was established, and iliac–lumbar muscle abscesses were found. The child was transferred to a surgical hospital, and sepsis, osteomyelitis of the right lateral mass of the sacrum, right-sided sacroiliitis, abscess of the right iliopsoas muscle, bilateral polysegmental pneumonia, and bilateral pleuritic were diagnosed. Surgical opening and drainage of the abscess of the lumbosacral muscle was performed. The study of abscess secretion detected Salmonella gr. B Chester, a resistance gene to penicillins, cephalosporins, and carbapenems. Therapy with off-label ciprofloxacin at 400 mg with pronounced positive dynamics. Cases of treatment of patients with atypical forms of salmonellosis show the need for further accumulation of experience, modification of treatment protocols, and verification of pathogens at an early stage for greater therapy effectiveness.