Saturveithan C, Arieff A, Premganesh G, Sivapathasundaram N
Depertment of Orthopaedics, Malacca Hospital, Malacca, Malaysia.
Malays Orthop J. 2014 Jul;8(2):52-4. doi: 10.5704/MOJ.1407.005.
A one year old boy was admitted with left shoulder pain with reduced range of motion of five days' duration associated. Inflammatory markers were raised and radiograph of the left shoulder revealed widening of the metaphysis of the proximal humerus. Empirically, he was started on intravenous C-penicillin and cloxacillin after initial joint aspiration yielded only synovial fluid with negative culture. Subsequent MRI revealed acute osteomyelitis of the proximal left humerus with concurrent septic arthritis of the shoulder joint. Cultures from the arthrotomy washout grew Salmonella sp, sensitive to ampicillin. He recovered following six weeks of intravenous unasyn ( ampicillin and sulbactum). This rare case of salmonella osteomyelitis in a non-sickle cell disease patient was diagnosed with serial laboratory and radiological studies and was successfully treated with adequate duration of antibiotics and operative intervention.
salmonella osteomyelitis, non-sickle cell disease, children.
一名1岁男童因左肩部疼痛伴活动范围减小入院,病程5天。炎症指标升高,左肩部X线片显示肱骨近端干骺端增宽。经验性治疗方面,在最初的关节穿刺仅抽出阴性培养结果的滑液后,开始静脉给予C-青霉素和氯唑西林。随后的磁共振成像显示左肱骨近端急性骨髓炎并伴有肩关节化脓性关节炎。关节切开冲洗液培养出对氨苄西林敏感的沙门氏菌。经六周静脉注射优立新(氨苄西林和舒巴坦)后康复。该例非镰状细胞病患者发生沙门氏菌骨髓炎的罕见病例,经系列实验室和影像学检查得以确诊,并通过足够疗程的抗生素治疗和手术干预成功治愈。
沙门氏菌骨髓炎;非镰状细胞病;儿童