Salmonella enterica serovar Ohio septic arthritis and bone abscess in an immunocompetent patient: a case report
1 Department of Internal Medicine and Clinical Immunology, Yokohama City University Graduate School of Medicine, 3-9, Fuku’ura, Kanazawa, Yokohama City, 236-0004, Kanagawa, Japan
2 Clinical Laboratory, Yokohama City University Hospital, 3-9, Fuku’ura, Kanazawa, Yokohama City, 236-0004, Kanagawa, Japan
3 Yokohama City Institute of Public Health, 1-2-17, Takigashira, Isogo, Yokohama City, 235-0012, Kanagawa, Japan
Journal of Medical Case Reports 2012, 6:204 doi:10.1186/1752-1947-6-204Published: 17 July 2012
Non-typhi Salmonella species cause severe extra-intestinal focal infection after occult bacteremia. Although the number of cases of non-typhi salmonellosis is increasing worldwide among patients with immunocompromising conditions such as human immunodeficiency virus infection, infection is uncommon in immunocompetent subjects. We report a case of septic arthritis and bone abscess due to a rare non-typhi Salmonella organism that developed after a prolonged asymptomatic period.
A 44-year-old Japanese immunocompetent man presented with acute-onset left knee pain and swelling. He had no history of food poisoning, and his most recent travel to an endemic area was 19 years ago. Salmonella enterica serovar Ohio was identified from samples of bone abscess and joint tissue. Arthrotomy and necrotic tissue debridement followed by intravenous ceftriaxone was successful.
Non-typhi Salmonella species only rarely cause extra-intestinal focal infections in immunocompetent patients. Our case suggests that non-typhi Salmonella species can cause severe focal infections many years after the occult bacteremia associated with food poisoning.