Acute hematogenous osteomyelitis of a closed fracture with chronic superinfection.

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.