Hamada Toru, Furukawa Shinya, Kikuchi Yoshio, Kubota Masashi, Mitsunaga Eiji
Internal Medicine, Seiyo Municipal Hospital, Seiyo, JPN.
Health Services Center, Ehime University, Matsuyama, JPN.
Cureus. 2024 Feb 27;16(2):e55034. doi: 10.7759/cureus.55034. eCollection 2024 Feb.
Nontyphoidal Salmonella commonly induces intestinal infections; however, spondylitis arising from this bacterium is exceedingly rare. A comprehensive review of the clinical attributes of nontyphoidal Salmonella-induced spondylitis in adult populations is lacking in the literature. We report a case of an 83-year-old female who presented with a fever lasting three days, accompanied by anorexia and pervasive malaise. A month prior, she had been prescribed celecoxib and had received a trigger point injection. The patient was initially diagnosed with acute pyelonephritis and treated with an antimicrobial regimen. However, a week later, although her fever persisted, there was no complaint of back pain. The discontinuation of celecoxib led to back pain. Subsequent urine and blood cultures, coupled with MRI findings, confirmed the diagnosis of pyogenic spondylitis attributable to the Salmonella O7 group. The patient's fever abated with the administration of antimicrobial agents, and her back pain subsided. The antimicrobial regimen was continued for 12 weeks, with no resurgence of fever or back pain following treatment. Local pain and fever are important indicators for the diagnosis of spondylitis caused by nontyphoidal Salmonella. It is critical to take an accurate history of non-steroidal anti-inflammatory drugs (NSAIDs) use, such as celecoxib, since NSAIDs can obscure the symptoms. Blood cultures are equally important, given their propensity to yield positive results in these patients.
非伤寒沙门氏菌通常会引发肠道感染；然而，由这种细菌引起的脊柱炎极为罕见。文献中缺乏对成年人群中非伤寒沙门氏菌所致脊柱炎临床特征的全面综述。我们报告一例83岁女性病例，该患者发热持续三天，伴有厌食和全身不适。一个月前，她曾服用塞来昔布并接受了触发点注射。患者最初被诊断为急性肾盂肾炎，并接受了抗菌治疗。然而，一周后，尽管她仍发热，但并无背痛主诉。停用塞来昔布后出现背痛。随后的尿液和血液培养，结合MRI检查结果，确诊为由O7群沙门氏菌引起的化脓性脊柱炎。给予抗菌药物后患者体温下降，背痛缓解。抗菌治疗持续了12周，治疗后未再出现发热或背痛。局部疼痛和发热是诊断非伤寒沙门氏菌所致脊柱炎的重要指标。准确了解非甾体抗炎药（如塞来昔布）的用药史至关重要，因为这类药物可能掩盖症状。鉴于血培养在这些患者中容易得出阳性结果，其同样重要。
