Salmonella vertebral osteomyelitis with bilateral psoas myositis in a patient with newly diagnosed diabetes: a case report and literature review
Year: 2025
Type: article
Study design: Case Report
Abstract: • First reported case of Salmonella vertebral osteomyelitis with bilateral psoas myositis. • Occurred in a newly diagnosed diabetic patient without gastrointestinal symptoms. • Initial treatment with ceftriaxone-ciprofloxacin failed; however, meropenem-ciprofloxacin achieved success. • Early MRI and blood culture were crucial for accurate diagnosis and treatment. • Emphasizes suspicion of SVO in diabetic patients with fever and back pain. Salmonella vertebral osteomyelitis (SVO) is a rare complication, occurring in approximately 0.8% of Salmonella infections. Bilateral psoas muscle involvement has not been previously documented. We report the first documented case of SVO with bilateral psoas myositis in a 56-year-old Vietnamese woman with newly diagnosed type 2 diabetes mellitus (HbA1c 9.2%). The patient presented with high fever (39°C), visual analogue (VAS) (8/10), and absence of gastrointestinal symptoms. Multiple antibiotic-susceptible Salmonella sp. were isolated from her blood culture. (Magnetic resonance imaging) MRI demonstrated L3 vertebral osteomyelitis with bilateral psoas muscle high signal, indicating active myositis. Initial treatment with ceftriaxone and ciprofloxacin was ineffective, necessitating escalation to meropenem combined with ciprofloxacin, which resulted in clinical improvement after 4 days. In summary, this exceptional case represents the first reported SVO with bilateral psoas myositis, emphasizing the importance of advanced imaging and aggressive antibiotic therapy in diabetic patients presenting with fever and back pain, even without gastrointestinal symptoms.
Source: IJID Regions
Authors: Le Viet Nghia, Do Xuan Tien, Cam Ba Thuc, Doi Ngoc Anh, Ngo Manh Linh, Nguyen Quoc Phuong
Institutions: Hanoi Medical University, Viet Duc Hospital
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,380
OpenAlex ID: W4414420604