We report two such cases. Case 1: A 30-year-old male presented with right forearm swelling and pain; examination revealed a non-mobile, fluctuant intramuscular swelling. Case 2: A 30-year-old female had a 3-month history of midline chest pain with a mobile, fluctuant swelling over the xiphisternum. In both cases, aspirated pus showed numerous pus cells with few Gram-negative bacilli. Culture revealed non-lactose fermenting, smooth convex colonies identified as Salmonella Typhi by biochemical tests, Vitek 2 (bioMérieux), and serology. The isolates were susceptible to ceftriaxone, ciprofloxacin, azithromycin, cotrimoxazole, and ampicillin, but resistant to chloramphenicol. Both patients were immunocompetent, with no history of trauma, diabetes, or haemoglobinopathy, and responded well to antibiotic therapy. These cases highlight the need for clinical awareness of atypical presentations of S. Typhi osteomyelitis and the importance of timely diagnosis in endemic regions.
Raina et al. (Thu,) studied this question.