Cervical Osteomyelitis With Paraspinal Abscess Caused by Salmonella Typhi in an Immunocompetent Adult: A Case Report

TL;DR

A healthy adult developed a rare spinal infection caused by Salmonella Typhi, requiring multiple surgeries and long-term treatment.

Contribution

Reports a rare case of cervical osteomyelitis and paraspinal abscess caused by S. Typhi in an immunocompetent adult.

Findings

Salmonella Typhi caused cervical vertebral osteomyelitis and paraspinal abscess in a previously healthy individual.

Diagnosis was confirmed by culturing abscess fluid, and treatment involved multiple surgeries and antibiotics.

The case highlights the need to consider Salmonella in spinal infections, even in immunocompetent patients.

Abstract

Salmonella Typhi infection typically presents as gastrointestinal illness but may rarely lead to severe systemic complications. Osteomyelitis is a recognized, although uncommon, extraintestinal manifestation that most often occurs in immunocompromised individuals or those with hemoglobinopathies. We report a rare case of cervical vertebral osteomyelitis and paraspinal abscess caused by S. Typhi in a previously healthy 37-year-old male. Initial imaging with CT and MRI revealed deep cervical and paraspinal abscesses with inflammatory changes suggestive of osteomyelitis, but no spinal canal involvement. The diagnosis was established through culture of intraoperative abscess fluid. Despite initial clinical improvement, recurrence of the abscess necessitated three surgical debridements and vacuum-assisted closure therapy. The patient completed an eight-week course of intravenous ertapenem and oral azithromycin and achieved full clinical and radiological resolution. This case underscores the importance of considering Salmonella species in the differential diagnosis of vertebral infections, even in immunocompetent hosts.

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