Extra-intestinal Manifestations of Salmonella in Immunocompetent Pediatric Patients: A Case Series.

INTRODUCTION: This case series discusses five cases of invasive Nontyphoidal Salmonella (iNTS) infections. These presentations are atypical in healthy children without immunodeficiency or hemoglobinopathy. METHODS: We present five cases of iNTS in otherwise healthy children that were not previously known to have established risk factors. An abridged literature review of iNTS was performed. RESULTS: The patients in this case series were older than previously documented reports of iNTS with a mean age of 12.4 years. Each patient was immunocompetent aside from hypogammaglobulinemia in case 5. These cases had variable presentations ranging from bacteremia, septic arthritis, abscesses, pyelonephritis, transaminitis and meningismus. Additionally, our patients had hospital durations with an average of 4.8 days. CONCLUSION: While iNTS most commonly affects pediatric patients less than 5 years of age with hemoglobinopathy or immunodeficiency, this is not always the case. Thus, a high index of suspicion is needed for iNTS: Blood cultures should be collected and focal infections ruled out. Additionally, patients should receive an immunologic and hematologic workup.