<i>Salmonella Typhi</i> mimicking Pott's disease: A case report and review of the literature

Background: Infectious spondylodiscitis, an infection that involves the intervertebral disc and adjacent vertebral body, often manifests as back pain, fever, and malaise. Although Staphylococcus aureus is the most commonly reported cause of infectious spondylodiscitis, other atypical organisms can also cause spinal infections. Salmonella enterica serovar Typhi has been rarely reported to cause spondylodiscitis. Method: Retrospective single-record review with informed written consent from the patient. Results: We present the case of an immunocompetent 67-year-old female patient with subacute intermittent back pain, weight loss, and a history of prolonged travel to India. MRI showed destructive T7–T8 spondylodiscitis with vertebral collapse, kyphotic deformity, and severe canal stenosis. Given the patient's presentation, epidemiology, and radiologic features, spinal tuberculosis was initially suspected. A biopsy of the spinal tissue grew S. Typhi by the third day of incubation. The patient was treated with a 6-week course of intravenous ceftriaxone. The patient's symptoms resolved over the course of treatment, and she remained clinically well with no signs of recurrent infection at 12-month follow-up. Conclusion: This case highlights S. Typhi as a rare cause of spondylodiscitis in immunocompetent individuals that can mimic Pott's disease clinically and radiographically. This case exemplifies the importance of maintaining a broad differential when evaluating spondylodiscitis, especially in patients who travel to regions that are endemic for atypical pathogens.