Non-typhoidal Salmonella Bacteremia as a Diagnostic Clue to Gastric Cancer With Isolated Bone Metastasis: A Case Report.

We report a rare case of Salmonella enterica bacteremia as the initial presentation of gastric adenocarcinoma with isolated bone metastasis. A 65-year-old woman presented with persistent lumbar and cervical pain, night sweats, tremors, and worsening respiratory failure. Blood cultures grew S. enterica, leading to targeted antibiotic treatment with ceftriaxone. Despite therapy, fever and inflammatory markers persisted. Upper endoscopy revealed an ulcerated gastric lesion, and biopsy confirmed signet ring cell gastric adenocarcinoma. Imaging showed diffuse vertebral lesions, and bone biopsy confirmed metastatic disease. The patient's condition was complicated by gastrointestinal bleeding and progressive decline, making curative treatment unfeasible; she was transitioned to palliative care. This case highlights non-typhoidal Salmonella (NTS) bacteremia as a possible early indicator of malignancy and emphasizes the need for thorough diagnostic evaluation in patients with unexplained bacteremia.