Acute Hematogenous Osteomyelitis of a Closed Fracture With Chronic Superinfection

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Abstract
Acute hematogenous salmonella osteomyelitis is rare among immunocompetent adults. In this study, the authors reported an unusual case of salmonella enteriditis osteomyelitis of the humerus complicated by methicillin-resistant Staphylococcus aureus superinfection and eventual chronic osteomyelitis in an immunocompetent host. Resection of the humeral head and a significant portion of the humeral shaft coupled with numerous surgical debridements and intravenously administered antibiotics led to resolution of symptoms. This case provides a rare example of acute hematogenous osteomyelitis complicating a closed fracture and demonstrates the difficulty associated with eradication of these specific organisms while emphasizing the principle of aggressive surgical debridement in cases of chronic osteomyelitis.