Salmonella spondylitis in non-sickle cell patients

This article was a retrospective study of Salmonella spondylitis in seven non-sickle cell anemic patients. The objective of this study was to clarify the clinical manifestations of spinal infection by Salmonella, and to select the proper method of treatment. Comparison with the reported 25 cases in the literature was also attempted. The clinical symptoms and signs, laboratory data, bony images, treatment modalities and outcomes were documented, and compared with the 25 cases in the English literatures. The patients all suffered from insidious onset of low back pain, with progressive increasing intensity. Leucocytosis (> 9000) and body temperature elevation (> 37°C) were noted in four cases. Positive cultures were mainly obtained from blood (5 cases) and surgical specimens (one case) before treatment. One patient also had positive culture in the stool and urine. Six patients underwent surgical debridement of the infected foci, while one patient received antibiotic treatment only. The outcome was good in the uncomplicated cases. One patient with concurrent aortic aneurysm died of sepsis. We stress that Salmonella infection can be found in the apparently healthy persons. In the endemic region, high suspicion is needed. Surgical debridement, bone grafting and two months of antibiotic treatment are recommended.