Case Report: Salmonella typhi Iliopsoas Abscess with Concomitant Sacroiliitis in a Young Immunocompetent Male: A Rare Case

Bhuvanesh Kumar Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India;

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Dipasha Agarwal Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India;

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Durga Shankar Meena Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India;

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Deepak Kumar Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India;

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Binit Sureka Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, India

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ABSTRACT.

Iliopsoas abscess is an infrequent condition characterized by the collection of pus in the iliopsoas compartment. The prevalence of the disease has been increasing in recent years with the emergence of various comorbidities and risk factors. The availability of newer imaging modalities has also improved the detection of new cases. Salmonellosis is an uncommon etiology in iliopsoas abscess and sacroiliitis. Most cases reported in the literature are associated with Staphylococcus aureus, Streptococci species, and Escherichia coli. Diabetes, hematological malignancies, HIV, and other immunocompromised states are important comorbidities/risk factors for iliopsoas abscess. We report a case of an 18-year-old male who presented with a history of fever and right hip pain for 10 days. Radioimaging revealed right sacroiliitis and iliopsoas abscess. Blood culture revealed pan-sensitive Salmonella typhi. After the prolonged course of antibiotics (intravenous ceftriaxone followed by oral levofloxacin), the patient improved with no further relapse in symptoms. Salmonella typhi should be an important differential of iliopsoas abscess in endemic regions after ruling out the common etiology such as S. aureus and Mycobacterium tuberculosis.

Author Notes

Current contact information: Bhuvanesh Kumar, Dipasha Agarwal, Durga Shankar Meena, and Deepak Kumar, Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur, India, E-mails: bhuwankumar755.bk@gmail.com, agarwaldipasha@gmail.com, dsmims14@gmail.com, and deepak1007sharma@gmail.com. Binit Sureka, Department of Diagnostic and Interventional Radiology, All India Institute of Medical Sciences, Jodhpur, India, E-mail: binitsurekapgi@gmail.com.

Address correspondence to Durga Shankar Meena, Department of Internal Medicine, All India Institute of Medical Sciences, Jodhpur 342005, India. E-mail: dsmims14@gmail.com
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