Clinical Report: A Spinal TB Mimic: Salmonella Dublin
Overview
This case report details the identification of Salmonella Dublin as the causative pathogen in a 14-year-old boy initially suspected of having spinal tuberculosis. The patient underwent surgical debridement and subsequent targeted antimicrobial therapy, resulting in significant clinical improvement.
Background
Spinal tuberculosis is a common concern in regions with high TB prevalence, often leading to misdiagnosis due to overlapping clinical features with other infections. Invasive nontyphoidal Salmonella, while rare, can present similarly and may lead to severe complications if not identified promptly. This case underscores the importance of accurate diagnosis in atypical presentations of spinal infections.
Data Highlights
No numerical data or trial data available in the source material.
Key Findings
Initial symptoms included fever, cough, lumbar pain, and weight loss.
Imaging revealed vertebral destruction and a psoas muscle abscess, raising suspicion for spinal tuberculosis.
Empirical anti-tuberculosis therapy was ineffective, prompting further investigation.
Surgical debridement and tissue culture identified Salmonella Dublin as the pathogen.
Targeted therapy with imipenem/cilastatin led to rapid clinical improvement.
Metagenomic next-generation sequencing (mNGS) proved crucial in pathogen identification.
Clinical Implications
Clinicians should consider invasive nontyphoidal Salmonella in the differential diagnosis of spinal infections, especially in TB-endemic areas. Early surgical intervention and targeted antimicrobial therapy can significantly improve outcomes in cases where initial treatments fail.
Conclusion
This case highlights the diagnostic challenges posed by atypical presentations of spinal infections and the critical role of surgical intervention and advanced diagnostic techniques in achieving accurate diagnosis and effective treatment.
