BMC Infectious Diseases | |
Osteomyelitis of a long bone due to Fusobacterium nucleatum and Actinomyces meyeri in an immunocompetent adult: A case report and literature review | |
Kyong Ran Peck2  Jae-Hoon Song2  Doo Ryeon Chung2  Cheol-In Kang2  Ki Sun Sung1  Yoon Jung Lee2  Jun Hee Lee2  Hye Yon Park2  Young Eun Ha2  Min Ji Lee2  | |
[1] Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea;Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea | |
关键词: Periodontitis; Osteomyelitis; Fusobacterium nucleatum; | |
Others : 1175330 DOI : 10.1186/1471-2334-12-161 |
|
received in 2012-03-26, accepted in 2012-07-06, 发布年份 2012 | |
【 摘 要 】
Background
Fusobacterium species are uncommon causes of osteomyelitis. These organisms are normal flora of the oral cavity. Therefore, they mostly cause osteomyelitis of the head and neck. Hematogenous osteomyelitis at distant sites other than the head and neck has rarely been reported in pediatric or immunocompromised patients. Here, we report the first case of osteomyelitis of a long bone combined with a muscle abscess due to Fusobacterium nucleatum in an otherwise healthy adult.
Case presentation
A 59-year-old Korean man was admitted for pain and swelling of the right lower leg, which had been persistent for two weeks. Magnetic resonance imaging showed osteomyelitis of the right fibula with a surrounding muscle abscess of the right lower leg. Incision and drainage was performed, and repetitive tissue cultures grew F. nucleatum. In this patient, it was presumed that recurrent periodontitis caused hematogenous seeding of F. nucleatum to a distant site leading to osteomyelitis with a muscle abscess. The patient was successfully treated with intravenous ampicillin-sulbactam for three weeks and oral amoxicillin-clavulanate for eight weeks. He also underwent repeated surgical drainage. He has no evidence of recurrence after seven months of follow-up.
Conclusions
Clinicians should be aware that F. nucleatum could be the etiologic agent of hematogenous osteomyelitis of a long bone in an immunocompetent patient.
【 授权许可】
2012 Lee et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20150428024937667.pdf | 710KB | download | |
Figure 1. | 102KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Naredo Sanchez E, de Cal IW, Alegre Bernal N, Martin Rodrigo MD, Jaeger JU, Del Pozo FC, Blanco AJ, Valenciano AC, Echevarria MC: Fusobacterium osteomyelitis of the pubic symphysis in a healthy soccer player. J Rheumatol 2000, 27(8):2047-2048.
- [2]Brook I: Fusobacterial infections in children. J Infect 1994, 28(2):155-165.
- [3]Roberts GL: Fusobacterial infections: an underestimated threat. Br J Biomed Sci 2000, 57(2):156-162.
- [4]Murray SJ, Lieberman JM: Fusobacterium osteomyelitis in a child with sickle cell disease. Pediatr Infect Dis J 2002, 21(10):979-981.
- [5]Beauchamp RD, Cimolai N: Osteomyelitis of the pelvis due to Fusobacterium nucleatum. Canadian journal of surgery Journal canadien de chirurgie 1991, 34(6):618-620.
- [6]Le Moal G, Juhel L, Grollier G, Godet C, Azais I, Roblot F: Vertebral osteomyelitis due to Fusobacterium species: report of three cases and review of the literature. J Infect 2005, 51(2):E5-9.
- [7]Stahlman GC, DeBoer DK, Green NE: Fusobacterium osteomyelitis and pyarthrosis: a classic case of Lemierre's syndrome. J Pediatr Orthop 1996, 16(4):529-532.
- [8]Wald ER: Risk factors for osteomyelitis. Am J Med 1985, 78(6B):206-212.
- [9]Lewis RP, Sutter VL, Finegold SM: Bone infections involving anaerobic bacteria. Medicine 1978, 57(4):279-305.
- [10]Brook I, Frazier EH: Anaerobic osteomyelitis and arthritis in a military hospital: A 10 year experience. Am J Med 1993, 94(1):21-28.
- [11]Han XY, Weinberg JS, Prabhu SS, Hassenbusch SJ, Fuller GN, Tarrand JJ, Kontoyiannis DP: Fusobacterial brain abscess: A review of five cases and an analysis of possible pathogenesis. J Neurosurg 2003, 99(4):693-700.
- [12]Germann G, Petracic A, Wittemann M, Raff T: Hematogenous osteomyelitis of the hand skeleton in adults after dental maxillary infections. Ann Plast Surg 1996, 37(1):106-110.
- [13]Brook I: Microbiology and management of joint and bone infections due to anaerobic bacteria. Journal of orthopaedic science: official journal of the Japanese Orthopaedic Association 2008, 13(2):160-169.
- [14]Williams MD, Kerber CA, Tergin HF: Unusual presentation of Lemierre's syndrome due to Fusobacterium nucleatum. J Clin Microbiol 2003, 41(7):3445-3448.
- [15]Bennett KW, Eley A: Fusobacteria: New taxonomy and related diseases. J Med Microbiol 1993, 39(4):246-254.
- [16]Goldstein EJ, Summanen PH, Citron DM, Rosove MH, Finegold SM: Fatal sepsis due to a beta-lactamase-producing strain of Fusobacterium nucleatum subspecies polymorphum. Clinical infectious diseases: An official publication of the Infectious Diseases Society of America 1995, 20(4):797-800.
- [17]Liu CY, Huang YT, Liao CH, Yen LC, Lin HY, Hsueh PR: Increasing trends in antimicrobial resistance among clinically important anaerobes and Bacteroides fragilis isolates causing nosocomial infections: emerging resistance to carbapenems. Antimicrob Agents Chemother 2008, 52(9):3161-3168.
- [18]Loivukene K, Naaber P: Antibiotic susceptibility of clinically relevant anaerobes in Estonia from 1999 to 2001. Anaerobe 2003, 9(2):57-61.
- [19]Jacinto RC, Montagner F, Signoretti FG, Almeida GC, Gomes BP: Frequency, microbial interactions, and antimicrobial susceptibility of Fusobacterium nucleatum and Fusobacterium necrophorum isolated from primary endodontic infections. J Endod 2008, 34(12):1451-1456.
- [20]Jamal W, Shahin M, Rotimi VO: Surveillance and trends of antimicrobial resistance among clinical isolates of anaerobes in Kuwait hospitals from 2002 to 2007. Anaerobe 2010, 16(1):1-5.
- [21]Gomes BP, Jacinto RC, Montagner F, Sousa EL, Ferraz CC: Analysis of the antimicrobial susceptibility of anaerobic bacteria isolated from endodontic infections in Brazil during a period of nine years. J Endod 2011, 37(8):1058-1062.
- [22]Kuriyama T, Williams DW, Yanagisawa M, Iwahara K, Shimizu C, Nakagawa K, Yamamoto E, Karasawa T: Antimicrobial susceptibility of 800 anaerobic isolates from patients with dentoalveolar infection to 13 oral antibiotics. Oral Microbiol Immunol 2007, 22(4):285-288.
- [23]van Winkelhoff AJ, Herrera D, Oteo A, Sanz M: Antimicrobial profiles of periodontal pathogens isolated from periodontitis patients in The Netherlands and Spain. J Clin Periodontol 2005, 32(8):893-898.