Septic arthritis due to Salmonella Typhi in children—A case series

S almonella enterica serotype Typhi is a pathogen specific only to humans and is one of the most extensively studied bacterial pathogens. However, it is not adequately understood in respect of its ability to establish persistent infections, which serve as reservoirs for disease transmission and associated morbidity and mortality.[1] The global burden of Typhi infections has been estimated at twenty million cases and two hundred thousand deaths each year [2]. Organisms commonly associated with septic arthritis include Staphylococcus aureus, Haemophilus influenzae, Streptococci, Gram negative rods like Klebsiella spp., gonococci, Spirochaetes like Borrelia burgdorferi, some Mycoplasma and several viruses [3]. Salmonella has never been considered an important cause of septic arthritis and whenever associated, it has invariably been a metastatic extension of non-typhoidal salmonella illness [3, 4]. Association of Salmonella Typhi with septic arthritis is an extremely rare clinical entity but data presented in this study seem to indicate that either salmonella arthritis is less noticed or this entity is an emerging phenomenon.