Extraintestinal Salmonella InfectionsAn Underdiagnosed Clinical Entity: A Case Series

Abstract

Extraintestinal salmonellosis can occur as a complication of enteric fever. In this case series, five clinically suspected cases of pyogenic meningitis and arthritis, a case of pyelonephritis suspected to be pyogenic or tubercular, a case of vertebral osteomyelitis suspected to be tuberculosis or malignancy, and a case of pyomyositis that clinically presented as a tumour were discussed. Although none of these cases were clinically suspected to be due to Salmonella, all were confirmed as extraintestinal salmonellosis based on microbiological evaluation. Salmonella should be suspected in acute inflammatory lesions that are unresponsive to empirical treatment. Instead of empirical antibiotics, culture and sensitivity-based antibiotics for the recommended duration are the only way to cure extraintestinal salmonellosis and prevent morbidity. Effective communication and correlation between the laboratory, clinician, and radiologist are essential for a definitive diagnosis. Histopathological and microbiological investigations should be done simultaneously to identify the definitive aetiology in all localised lesions presenting with necrosis/inflammatory response. This case series presents five cases of extraintestinal salmonellosis with serious complications, including meningitis, pyelonephritis, osteomyelitis, septic arthritis, and pyomyositis, each with varied clinical presentations.