J Pediatr Infect Dis 2018; 13(01): 084-088
DOI: 10.1055/s-0037-1602385
Case Report
Georg Thieme Verlag KG Stuttgart · New York

Prolonged Course of Salmonella Pelvic Osteomyelitis in an Immunocompetent African American Child: A Case Report and Review of the Literature

Matthew Bauer
1  Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
,
Jessica Kumar
1  Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
2  Department of Pediatrics, University Hospitals Cleveland, Cleveland, Ohio, United States
,
Michael Jacobs
1  Case Western Reserve University School of Medicine, Cleveland, Ohio, United States
3  Department of Clinical Pathology, Division of Medical Microbiology, University Hospitals Cleveland, Cleveland, Ohio, United States
› Author Affiliations
Further Information

Publication History

16 February 2017

22 March 2017

Publication Date:
20 April 2017 (eFirst)

Abstract

Salmonella pelvic osteomyelitis is an uncommon manifestation of acute hematogenous osteomyelitis in children without risk factors such as hemoglobinopathies or immunodeficiency syndromes. Here we report a case of prolonged pelvic osteomyelitis in an immunocompetent child who remained culture negative and refractory to both antibiotic therapy and nonsurgical intervention for 7 months. Definitive microbiological diagnosis and treatment were only obtained after open surgical exploration with substantial debridement. We therefore recommend earlier consideration of aggressive surgical intervention in cases of pelvic osteomyelitis in which no organism is definitively implicated or symptoms continue despite prolonged courses of antibiotics, both for source control and definitive diagnosis.