Osteomyelitis of a long bone due to Fusobacterium nucleatum and Actinomyces meyeri in an immunocompetent adult: A case report and literature review

BMC Infectious Diseases

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.

【 图 表 】

Figure 1.

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