Osteomielite de fêmur e sepse por Salmonella em criança imunocompetente
Keywords:
osteomyelitis, salmonella infections, child, sepsisAbstract
Osteomyelitis due to Salmonella is well-documented in patients with sickle cell anemia or immunodeficiencies, especially those complement related. Systemic infections by these bacteria, apart from intestinal origin, are uncommon in the immunocompetent pediatric population. A previously healthy 10 year old child presented with 7 days of fever and pain in his right hip, progressively worsening. Evolved with severe sepsis and need for Intensive Care admission; magnetic resonance imaging found osteomyelitis in the greater trochanter of the right femur. Underwent two surgical interventions for draining purulent material, were non-typhi Salmonella grew in cultures. Antibiotic treatment was with ceftriaxone and gentamicin, he presented transinfectious hepatitis and respiratory failure due to atelectasis. Hospital discharge was after 12 days, intravenous home treatment continued for 6 weeks in total; preliminary investigation for immunodeficiencies and hemoglobinopathies were negative. Posteriorly, fully recovered the affected limb’s mobility. Osteomyelitis due to unusual bacteria should be suspected even in immunocompetent individuals, especially when initial treatment fails.
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