Osteomyelitis due to Salmonella enterica subsp. arizonae: the price of exotic pets

We describe a 31-year-old immunocompromised patient who developed sepsis and osteomyelitis due to Salmonella enterica subsp. arizonae secondary to exposure to iguana and snakes kept as pets at her home, and review all 23 previously published cases of bone and joint infections due to this organism, for a total of nine children and 15 adults. Eleven of the adults were female (73%), compared with three (33%) of the children (p <0.01). Significant underlying illnesses were present in all 15 adults and in five children (55%, p <0.05); 10 (77%) of the adults were immunosuppressed, compared with one child only (17%) (p <0.05). In ten of the adults the knee was infected (67%), compared with one child only (11%, p <0.01). Antibiotic therapy was prolonged in both adults and children, and in most cases consisted of 4–6 weeks of parenteral treatment. Complete cure and survival was attained in 11 of 15 adults (73%) and all nine children (NS). Optimal antibiotic treatment probably consists of ceftriaxone or a fluoroquinolone, if the organism is susceptible.