title: Systemic leptospirosis followed by salmonella vertebral osteomyelitis without sickling or immunosuppression.
abstract: METHODS
  The clinical history of a healthy young patient who acquired systemic leptospirosis followed by salmonella vertebral osteomyelitis was studied in detail, and compared to the histories of leptospirosis and salmonella vertebral osteomyelitis reported in the literature.
  
  
  OBJECTIVE
  To alert the medical community about this unusual association of infectious diseases in a healthy patient without sickling or immunosuppression.
  
  
  BACKGROUND
  Human leptospirosis has been intensively studied, and there are several reports of salmonella vertebral osteomyelitis in patients without sickling. However, the combination of these entities in a single healthy patient is unexpected.
  
  
  METHODS
  The extensive literature on human leptospirosis and salmonella vertebral osteomyelitis was reviewed in detail, in correlation with this patient's clinical history and imaging studies.
  
  
  RESULTS
  The patient had no previous medical history. He contracted systemic leptospirosis when swimming in a lake contaminated with the urine of infected animals. As his leptospirosis symptoms resolved with doxycycline, he experienced increasing thoracolumbar spine pain, because of salmonella vertebral osteomyelitis, which responded to amoxicillin.
  
  
  CONCLUSIONS
  Leptospirosis may have caused gut mucosal vasculitis, allowing salmonella to enter the bloodstream and infect the spine.
authors.affiliation: Shriners Hospital for Children, Spokane, WA 99210-2472, USA. wosebold@shrinenet.org
authors.forename: William R
authors.initials: WR
authors.lastname: Osebold
mesh_terms: D000293:Adolescent; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D004318:Doxycycline / Q000627:therapeutic use; D006801:Humans; D007922:Leptospirosis / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D008297:Male; D010019:Osteomyelitis / Q000382:microbiology* / Q000473:pathology; D012480:Salmonella Infections / Q000150:complications* / Q000188:drug therapy / Q000473:pathology; D013122:Spinal Diseases / Q000382:microbiology* / Q000473:pathology; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin; D004318:Doxycycline