# Case Report: A case of Salmonella spondylitis masquerading as tuberculosis in a child

## TL;DR

A 14-year-old boy was misdiagnosed with tuberculosis but later found to have a rare Salmonella infection causing spinal issues.

## Contribution

Highlights the importance of considering uncommon infections like Salmonella in differential diagnoses resembling tuberculosis.

## Key findings

- Salmonella Dublin was identified as the causative agent after initial tuberculosis treatment failed.
- Imaging showed spinal damage and abscesses consistent with invasive Salmonella infection.
- Targeted antimicrobial therapy based on susceptibility testing led to successful treatment outcomes.

## Abstract

Salmonella typically causes gastroenteritis and rarely leads to invasive infections.

A 14-year-old boy, without a definitive history of an unsanitary diet or open wounds, was residing in an area with a high prevalence of tuberculosis. His primary symptoms included fever, cough, lumbar pain, and weight loss. The initial pathogen test was negative. Medical imaging revealed pulmonary nodules, intervertebral space narrowing, vertebral bone destruction, and a psoas muscle abscess. Empirical antibiotic therapy and diagnostic anti-tuberculosis treatment yielded poor results. Ultimately, pathogen testing of the surgically excised lesion identified Salmonella Dublin. Antimicrobial therapy guided by susceptibility testing yielded favorable outcomes.

Empirical therapy is often necessary during the initial phase of treatment. However, clinicians should consider uncommon conditions and employ appropriate approaches to obtain pathogen-specific test results, which can guide targeted therapeutic strategies when the anticipated clinical outcome is suboptimal.