Balakumar Balasubramaniam, Gangadharan Sangeet, Ponmudi Nithya, Kumar Satish, Prakash John Jude, Palocaren Thomas
Paediatric Orthopaedic Unit, Christian Medical College, Vellore, 632004, India.
Dept of Child Health, Christian Medical College, Vellore, 632004, India.
J Clin Orthop Trauma. 2017 Jul-Sep;8(3):293-297. doi: 10.1016/j.jcot.2017.05.008. Epub 2017 May 31.
Salmonella osteomyelitis in immunocompromised individuals with sickle cell anaemia is well documented. Its occurrence in immunocompetent children is rare.
All pus culture positive cases of salmonella typhi between the period 2009 to 2014 were reviewed and only those children without sickle cell disease or trait were considered further.
Eighty five patients had positive cultures. Of these only three children had culture positive Salmonella septic arthritis in the absence of sickle cell disease. Two children had shoulder septic arthritis while one had hip septic arthritis.
Our case series highlights the possibility of salmonella typhi osteomyelitis in immunocompetent individuals. Clinicians should be aware of this presentation which is usually delayed due to the atypical organism and lack of clinical response in the initial stages, as disastrous sequelae of septic arthritis may result if prompt treatment is not initiated in time.
免疫功能低下的镰状细胞贫血患者发生沙门氏菌骨髓炎已有充分记录。其在免疫功能正常儿童中的发生较为罕见。
回顾了2009年至2014年期间所有伤寒沙门氏菌脓液培养阳性的病例，仅进一步考虑那些没有镰状细胞病或特征的儿童。
85例患者培养结果呈阳性。其中只有3名儿童在没有镰状细胞病的情况下培养出阳性的沙门氏菌败血症性关节炎。2名儿童患有肩部败血症性关节炎，1名患有髋部败血症性关节炎。
我们的病例系列突出了免疫功能正常个体发生伤寒沙门氏菌骨髓炎的可能性。临床医生应意识到这种表现，由于病原体不典型且在初始阶段缺乏临床反应，这种表现通常会延迟出现，如果不及时开始及时治疗，可能会导致败血症性关节炎的灾难性后果。
