Kato Hideaki, Ueda Atsuhisa, Tsukiji Jun, Sano Kayoko, Yamada Mikiko, Ishigatsubo Yoshiaki
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.
J Med Case Rep. 2012 Jul 17;6:204. doi: 10.1186/1752-1947-6-204.
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.
非伤寒沙门氏菌在隐匿性菌血症后可引发严重的肠外局灶性感染。尽管在全球范围内,非伤寒沙门氏菌病在诸如人类免疫缺陷病毒感染等免疫功能低下的患者中病例数不断增加,但在免疫功能正常的个体中感染并不常见。我们报告一例由罕见的非伤寒沙门氏菌引起的化脓性关节炎和骨脓肿病例,该病例在长时间无症状期后发病。
一名44岁免疫功能正常的日本男性因急性发作的左膝疼痛和肿胀前来就诊。他无食物中毒史,最近一次前往流行地区是在19年前。从骨脓肿和关节组织样本中鉴定出肠炎沙门氏菌俄亥俄血清型。关节切开术和坏死组织清创术,随后静脉注射头孢曲松治疗取得成功。
非伤寒沙门氏菌在免疫功能正常的患者中极少引起肠外局灶性感染。我们的病例表明,非伤寒沙门氏菌可在与食物中毒相关的隐匿性菌血症多年后引发严重的局灶性感染。