Salmonella infection superimposed on Letterer-Siwe's disease resembling miliary Tuberculosis

Abstract

A 2 ½-year old boy in presented with a history of purulent otitis media and cutaneous abscesses in the frontal and occipital region since one year prior to admission. Later, hepatosplenomegaly, adenopathies and skin lesions developed. X-rays showed osteolysis of the skull over the abscess and military image of the lungs as well as a small lytic defect in the proximal left humerus. With respect to the high occurrence of Tuberculosis in this country an antituberculosis therapy was started without any noticeable effect. A skin biopsy revealed histiocytosis X and in cultures from abscesses grew Salmonella typhi B. Thus, Letterer-Siwe's disease was diagnosed on which a Salmonella infection was superimposed mimicking miliary Tuberculosis.