L-Spine Spondylitis and Epidural Abscess Caused by Group C1 Salmonella Leading to Severe Neurological Complication in a Patient with Systemic Lupus Erythematosus

Abstract

Salmonella infection is encountered frequently in the immunosuppressed patients and in those with diseases such as systemic lupus erythematosus(SLE) and lymphoma. They can present with septicemia, septic arthritis or subcutaneous abscess, which seldom invades the nervous system. We present a 58-year-old male patient with underlying diseases of G6PD deficiency, and SLE under treatment with corticosteroid who had L-spine spondylitis and epidural abscess caused by Salmonella group C1. Inadequate treatment of Salmonella infection previously may play an important role. The severe complications of Salmonella spondylitis and epidural abscess led to bilateral leg weakness and numbmess. After 2 weeks of intravenous ceftriaxone, laminectomy of the L2-3 and prolonged oral ciprofloxacin therapy, the neurological deficit recovered 3 months later. The case reminds us that spinal infection caused by Salmonella should be considered if the immunosuppressed patient is febrile and back pain. Surgical intervention is necessary when this severe complication occurs and adequate antibiotics are also important.