Prolonged Course of Salmonella Pelvic Osteomyelitis in an Immunocompetent African American Child: A Case Report and Review of the Literature

Abstract

Abstract Salmonella pelvic osteomyelitis is an uncommon manifestation of acute hematogenous osteomyelitis in children without risk factors such as hemoglobinopathies or immunodeficiency syndromes. Here we report a case of prolonged pelvic osteomyelitis in an immunocompetent child who remained culture negative and refractory to both antibiotic therapy and nonsurgical intervention for 7 months. Definitive microbiological diagnosis and treatment were only obtained after open surgical exploration with substantial debridement. We therefore recommend earlier consideration of aggressive surgical intervention in cases of pelvic osteomyelitis in which no organism is definitively implicated or symptoms continue despite prolonged courses of antibiotics, both for source control and definitive diagnosis.