DOI QR코드

DOI QR Code

Pyogenic Spondylitis Caused by Nontyphoidal Salmonella in an Immunocompetent Child

정상 면역 소아에서 발생한 비장티푸스 살모넬라 화농성 척추염

  • Baek, Jee Yeon (Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Shin, Jehee (Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Lim, Sungmin (Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Kang, Ji-Man (Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine) ;
  • Ahn, Jong Gyun (Department of Pediatrics, Severance Children's Hospital, Yonsei University College of Medicine)
  • 백지연 (연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아청소년과) ;
  • 신제희 (연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아청소년과) ;
  • 임성민 (연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아청소년과) ;
  • 강지만 (연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아청소년과) ;
  • 안종균 (연세대학교 의과대학 소아과학교실, 세브란스 어린이병원 소아청소년과)
  • Received : 2021.09.03
  • Accepted : 2021.10.27
  • Published : 2021.12.25

Abstract

Pyogenic spondylitis, an extremely rare complication of nontyphoidal Salmonella infection in immunocompetent children, occurs more commonly in patients with hemoglobinopathies such as sickle cell disease or in immunocompromised patients. In this study, we report a case of pyogenic spondylitis in a previously healthy 13-year-old immunocompetent adolescent, who presented with prolonged fever and right upper quadrant pain. Stool culture results comfirmed nontyphoidal Salmonella infection, and the patient was diagnosed with pyogenic spondylitis caused by nontyphoidal Salmonella based on additional imaging studies performed for evaluation of the patient's prolonged fever. This case highlights the importance of culture studies for evaluation of patients with fever of unknown origin and also the importance of detailed investigations for early detection of complications of extra-intestinal infections in patients with an unusual clinical course of salmonellosis.

비장티푸스 살모넬라균에 의한 화농성 척추염은 면역이 정상인 소아청소년에서는 매우 드문 질환으로, 주로 면역저하자나 낫적혈구병과 같은 혈색소병을 가진 환자들이 이 질환의 위험군으로 알려져 있다. 본 증례는 발열과 우상복부 통증으로 내원한 정상 면역을 가진 건강한 13세 청소년에서 대변 배양 검사를 통하여 비장티푸스 살모넬라균을 확인하고, 지속된 발열에 대하여 추가 영상 검사를 통하여 화농성 척추염이 합병되었음을 확인한 증례로, 불명열의 검사로 배양 검사의 중요성을 인식하게 하고, 일반적이지 않은 살모넬라증의 임상경과를 보이는 경우에는 장외 국소감염의 합병증에 대하여 철저하게 조사하는 것이 중요함을 보여준다.

Keywords

References

  1. Cohen JI, Bartlett JA, Corey GR. Extra-intestinal manifestations of salmonella infections. Medicine (Baltimore) 1987;66:349-88. https://doi.org/10.1097/00005792-198709000-00003
  2. Hohmann EL. Nontyphoidal salmonellosis. Clin Infect Dis 2001;32:263-9. https://doi.org/10.1086/318457
  3. Wen SC, Best E, Nourse C. Non-typhoidal Salmonella infections in children: review of literature and recommendations for management. J Paediatr Child Health 2017;53:936-41. https://doi.org/10.1111/jpc.13585
  4. Bula-Rudas FJ, Rathore MH, Maraqa NF. Salmonella infections in childhood. Adv Pediatr 2015;62:29-58. https://doi.org/10.1016/j.yapd.2015.04.005
  5. Lee S, Lee HN, Yang H, Kang J, Kim N, Sin Y, et al. A case of septic arthritis of the knee joint due to group D non-typhoidal Salmonella. Infect Chemother 2012;44:303-6. https://doi.org/10.3947/ic.2012.44.4.303
  6. Molyneux EM, Mankhambo LA, Phiri A, Graham SM, Forsyth H, Phiri A, et al. The outcome of nontyphoidal salmonella meningitis in Malawian children, 1997-2006. Ann Trop Paediatr 2009;29:13-22. https://doi.org/10.1179/146532809X401980
  7. Santos EM, Sapico FL. Vertebral osteomyelitis due to salmonellae: report of two cases and review. Clin Infect Dis 1998;27:287-95. https://doi.org/10.1086/514668
  8. Librianto D, Suwarto S, Imran D, Pramukti H, Saleh I, Ipang F, et al. An extremely rare case of upper thoracic salmonella infection. Orthop Res Rev 2021;13:107-12.
  9. Cheng W, Lian K, Luo D, Lin D, Feng W, Xian H, et al. Salmonella potsdam causing lumbar vertebral osteomyelitis: a case report. Medicine (Baltimore) 2018;97:e0682. https://doi.org/10.1097/MD.0000000000010682
  10. Myojin S, Kamiyoshi N, Kugo M. Pyogenic spondylitis and paravertebral abscess caused by Salmonella Saintpaul in an immunocompetent 13-year-old child: a case report. BMC Pediatr 2018;18:24. https://doi.org/10.1186/s12887-018-1010-5
  11. Chen M, Wang R, Shan J, Tang H. Salmonella enteritis spondylitis of thoracic spine: a case report and review of the literature. BMC Surg 2020;20:180. https://doi.org/10.1186/s12893-020-00841-5
  12. Gill AN, Muller ML, Pavlik DF, Eldredge JD, Johnston JJ, Eickman MM, et al. Nontyphoidal Salmonella Osteomyelitis in immunocompetent children without hemoglobinopathies: a case series and systematic review of the literature. Pediatr Infect Dis J 2017;36:910-2. https://doi.org/10.1097/INF.0000000000001555