A RARE CASE REPORT IN THE CHILDHOOD AGE GROUP: SALMONELLA OSTEOMYELITIS OF THE RADIUS

Year 2020, Volume: 5 Issue: 4, 115 - 122, 31.12.2020

Yaşar Dinçel , Abdülkadir Sarı , Mehmet Ümit Çetin , Melih Güney , Burak Günaydın , Erdem Can

Abstract

Introduction: Salmonella osteomyelitis is a rare condition predominantly seen in hemoglobinopathies such as sickle cell anemia or thalassemia. Very few cases have been reported in the literature in children without predisposing factors. Here, we present a case of Salmonella osteomyelitis developing in the radius of an immunocompetent 6-year-old child without any known predisposing conditions.

Case report: A 6-year-old patient applied to the pediatric emergency department with complaints of pain in the left forearm and 39.5 degrees Celcius fever, which has been going on for 20 days after the fall. On radiographs, lytic lesions were detected along the Radius and an infiltrative type lesion was observed in MRI. Samples were taken for bone culture and pathological examination under general anesthesia in the operating room due to suspicion of osteomyelitis or malignant lesions. There was very intensive Salmonella species growth in culture. The patient was given 400 mg vancomycin intravenously every 8 hours, and 1 g ceftriaxone intravenously every 12 hours for 3 weeks after the pediatric consultation. The patient was followed up on an outpatient basis, with 300 mg of oral cefuroxime treatment every 12 hours for 2 weeks. MRI and X-Ray imaging was performed at 6th postoperatively. It was observed that the lytic lesion decreased significantly in the radius. On the 14th postoperative month, MRI imaging showed that the lesion disappeared.

Conclusion: Rare pathogens should be considered in the differential diagnosis of patients with prolonged insidious symptoms and appropriate bacterial cultures should be taken for specific antibiotic therapy.

Keywords

osteomyelitis, salmonella, child, radius

ÇOCUKLUK YAŞ GRUBUNDA NADİR GÖRÜNEN BİR OLGU SUNUMU: RADIUS'TA SALMONELLA OSTEOMYELİTİ

Abstract

Giriş: Salmonella osteomiyeliti, orak hücreli anemi veya talasemi gibi hemoglobinopatilere eşlik eden nadir bir durumdur. Literatürde predispozan faktörlerin olmadığı çocuklarda çok az vaka bildirilmiştir. Burada, bilinen herhangi bir predispozan durum olmaksızın immünokompetan 6 yaşındaki bir çocuğun yarıçapında gelişen bir Salmonella osteomiyeliti olgusunu sunuyoruz.
Olgu sunumu: Altı yaşında hasta, düşme sonrası 20 gündür devam eden sol ön kolda ağrı ve 39,5 derece Celcius ateşi yakınmalarıyla çocuk acil servisine başvurdu. Radyografilerde Radius boyunca litik lezyonlar tespit edildi ve MRG'de Radius’ta infiltratif tipte lezyon izlendi. Osteomiyelit veya malign lezyon şüphesiyle ameliyathanede genel anestezi altında kemik kültürü ve patolojik inceleme için örnekler alındı. Kültürde çok yoğun Salmonella Species üremesi oldu. Pediatrik konsültasyondan sonra hastaya her 8 saatte bir 400 mg vankomisin ve 3 hafta boyunca her 12 saatte bir 1 g seftriakson intravenöz olarak verildi. Hasta 2 hafta boyunca 12 saatte bir 300 mg oral sefuroksim tedavisi ile ayaktan takip edildi. Postoperatif 6. sırada MR ve X-Ray görüntüleme yapıldı. Yarıçapta litik lezyonun önemli ölçüde azaldığı görüldü. Postoperatif 14. ayda MR görüntülemesinde lezyonun kaybolduğu görüldü.
Sonuç: Uzun süreli sinsi semptomları olan hastaların ayırıcı tanısında nadir patojenler düşünülmelidir ve hedefe yönelik antibiyotik tedavisi için uygun kültürlerin alınması gerekmektedir.

Keywords

osteomyelit, salmonella, çocuk, radius

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