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Nontyphoidal Salmonella Osteomyelitis in an Immunocompetent Adult Without Preceding Symptoms

A 23-year-old man presented with a painful swelling of his left shin approximately 5 weeks after a very mild trauma. He had not experienced fever, abdominal pain, or diarrhea. Magnetic resonance images were compatible with chronic osteomyelitis. The cultures of the bone biopsy showed growth of Salmonella enterica serovar Enteritidis. Blood cultures remained sterile, there were no signs of a carrier state, and no immune deficiency could be found. After surgical debridement, the patient was treated with ceftriaxone and co-trimoxazole and later ciprofloxacin because of an allergic reaction. Nontyphoidal Salmonella osteomyelitis is rare in immunocompetent adults without a hemoglobinopathy. The treatment consists of surgical debridement and prolonged antibiotics.