Rare form of salmonellosis

Rare forms of salmonellosis refer to uncommon clinical manifestations of infection caused by non-typhoidal Salmonella species that go beyond the typical gastroenteritis presentation. While common salmonellosis typically causes self-limited diarrhea, fever, and abdominal cramps, rare forms can involve extraintestinal manifestations including bacteremia, endovascular infections (such as mycotic aneurysms and endocarditis), osteomyelitis, septic arthritis, meningitis, and focal abscesses in various organs including the spleen, liver, and soft tissues. These rare presentations are more likely to occur in immunocompromised individuals, including those with HIV/AIDS, sickle cell disease, malignancies, or those on immunosuppressive therapy, as well as in neonates and the elderly. The disease can affect multiple body systems depending on the site of dissemination, including the cardiovascular system, musculoskeletal system, central nervous system, and hepatobiliary system. Rare forms of salmonellosis may present with prolonged or recurrent fever, localized pain, signs of sepsis, or organ-specific dysfunction. Diagnosis relies on culture of Salmonella from blood, cerebrospinal fluid, joint fluid, or other normally sterile sites. Treatment of rare and invasive forms of salmonellosis requires targeted antibiotic therapy, typically with fluoroquinolones (such as ciprofloxacin), third-generation cephalosporins (such as ceftriaxone), or azithromycin, often administered intravenously and for prolonged courses depending on the site of infection. Surgical intervention may be necessary for endovascular infections, abscesses, or infected prosthetic devices. Antimicrobial resistance is an increasing concern, and susceptibility testing is essential to guide therapy. Management of underlying immunodeficiency is also a critical component of treatment.

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