An atypical case of spondylitis due to non-typhoidal Salmonella in adults: A case report and literature review

Abstract

Abstract Background Non-typhoidal Salmonella commonly induces intestinal infections; however, spondylitis arising from this bacterium is exceedingly rare. A comprehensive review of the clinical attributes of non-typhoidal Salmonella-induced spondylitis in adult populations is lacking. Case presentation: Upon admission to our medical institution, an 83-year-old woman presented with a fever lasting 3 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, a complaint of back pain was absent. Discontinuation of celecoxib led to back pain. Subsequent urine and blood cultures, coupled with magnetic resonance imaging findings, confirmed the diagnosis of pyogenic spondylitis attributable to the Salmonella O7 group. With administration of antimicrobial agents, the patient’s fever abated and her back pain subsided. The antimicrobial regimen continued for 12 weeks, with no resurgence of fever or back pain following treatment. Conclusions Spondylitis resulting from non-typhoidal Salmonella is rare, with local pain and fever serving as pivotal diagnostic indicators. It is critical to take an accurate history of non-steroidal anti-inflammatory (NSAIDs) use, such as the use of celecoxib, because of the potential of NSAIDs to obscure symptoms. Blood cultures are equally important, given the propensity to yield positive results in these cultures.