Ceftriaxone-resistant Salmonella septicemia and osteomyelitis in sickle cell disease adults.
The majority of data evaluating Salmonella infections in sickle cell anemia (SCD) comes from studies performed in children. We report a SCD adult who presented with ceftriaxone-resistant Salmonella bacteremia. After appropriate initial therapy, persistent back pain prompted evaluation by magnetic resonance imaging of the spine, which revealed osteomyelitis and a psoas abscess. The patient responded to percutaneous drainage and antibiotics. This report summarizes some of the findings of large SCD studies evaluating Salmonella bacteremia and osteomyelitis, focusing on adults. Our case exemplifies the need for antibiotic coverage for Salmonella species in adult SCD patients with septicemia. We argue that imaging studies looking for osteomyelitis should be done routinely in SCD patients with Salmonella bacteremia.
Morgan
James S
JS
Division of Hematology and Medical Oncology, Department of Medicine, University of Louisville, J.G. Brown Cancer Center. Louisville, KY 40202, USA.
Laber
Damian A
DA
D000328:Adult; D000755:Anemia, Sickle Cell / Q000453:epidemiology*; D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D000890:Anti-Infective Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002443:Ceftriaxone / Q000494:pharmacology / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000008:administration & dosage / Q000627:therapeutic use; D015897:Comorbidity; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D010019:Osteomyelitis / Q000175:diagnosis / Q000453:epidemiology*; D016659:Psoas Abscess / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology; D012480:Salmonella Infections / Q000453:epidemiology*; D012479:Salmonella paratyphi C / Q000187:drug effects; D018805:Sepsis / Q000453:epidemiology* / Q000382:microbiology
D000900:Anti-Bacterial Agents; D000890:Anti-Infective Agents; D002939:Ciprofloxacin; D002443:Ceftriaxone