Actinomycotic osteomyelitis of a long bone in an immunocompetent adult: a case report and literature review

Ryu, Dong Jin; Jeon, Young-Chan; Kwon, Hea Yoon; Choi, Suk Jin; Roh, Tai Suk; Kim, Myung Ku

doi:10.1186/s12891-019-2576-2

Cited by 6 publications

(4 citation statements)

References 19 publications

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“…Both a positive culture of Actinomycetes europaeus and a typical histopathology were observed in our reported case. In cases of actinomycotic osteomyelitis affecting extrafacial bone, the degree of progression, soft tissue reaction, existing sinus, and radiological findings should be considered [ 12 ]. Furthermore, molecular techniques, such as 16 S rRNA gene sequencing and mass spectrometry, can be used for the identification of Actinomyces [ 13 ].…”

Section: Discussionmentioning

confidence: 99%

Musculoskeletal actinomycosis in children: a case report

et al. 2021

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Background Actinomycosis is a rare infectious disease caused by Actinomyces, especially in children. Here, we present a case of musculoskeletal actinomycosis in a 5-year-old girl from China. Case presentation A 5-year-old girl presented with recurrent episodes of fever, pain, erythema, swelling, and festering sores on the right lower extremity, and pus was discharged from a sinus in the right foot. Magnetic resonance imaging (MRI) suggested subcutaneous soft tissue infection and osteomyelitis of the right crus. A bacterial culture of pus extracted from a festering sore on the right popliteal fossa detected the growth of Actinomycetes europaeus. The patient was cured with 7 weeks of treatment with intravenous ampicillin-sulbactam, followed by 6 weeks of treatment with oral amoxicillin-clavulanate with surgical debridement and drainage. There were no symptoms of recurrence during the 15-month period of follow-up. Conclusions Pediatric actinomycosis is a rare and challenging infectious disease. Early accurate diagnosis and optimal surgical debridement are important for the management of pediatric actinomycosis.

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Section: Discussionmentioning

confidence: 99%

Musculoskeletal actinomycosis in children: a case report

et al. 2021

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“…32 To date, only a sparse amount of cases of long bone osteomyelitis due to Actinomyces bacteria (Table 1) have been published in the medical literature. 40 Of these, few have involved the lower leg, and to the best of our knowledge, none have been associated with metallic hardware placed for the internal fixation of bone fractures. For the most part, reported long bone actinomycotic infections predominantly have been associated with chronic decubiti or followed environmental contamination of exposed bone resulting from a complex compound fracture.…”

Section: Actinomycotic Osteomyelitismentioning

confidence: 99%

“…To date, only a sparse amount of cases of long bone osteomyelitis due to Actinomyces bacteria (Table 1) have been published in the medical literature 40 . Of these, few have involved the lower leg, and to the best of our knowledge, none have been associated with metallic hardware placed for the internal fixation of bone fractures.…”

Section: Actinomycotic Osteomyelitismentioning

confidence: 99%

An Actinomyces Long-Bone Osteomyelitis Case Report and Review

Bush

Viggiano

Tayon

et al. 2021

Infect Dis Clin Pract

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Historically, anaerobic bacteria as monomicrobial pathogens or components of polymicrobial infections have been found to play a minor role in osteomyelitis. Various Actinomyces species reside as constituents of the normal human microbial flora found in the oropharynx and in the most people may also be present as commensal microorganisms in the gastrointestinal, genitourinary, and, to a lesser degree, the upper respiratory tracts. Bone infections due to Actinomyces species are relatively uncommon and usually associated with concomitant cervicofacial disease. To date, only a sparse amount of cases of long bone osteomyelitis due to Actinomyces bacteria have been published in the medical literature. We report a case of monomicrobial subacute late-onset tibia bone osteomyelitis involving Actinomyces presenting 10 years after an open reduction and internal fixation surgical procedure performed to stabilize a traumatic fracture and review actinomycotic osteomyelitis including the rare association of Actinomyces odontolyticus with long bone infections.

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“…Furthermore, osteomyelitis is one of the most difficult infections to cure and is caused by hematogenous spread in 22.97% of cases [ 11 ]. A small number of cases of actinomycotic osteomyelitis in the legs of healthy patients resulting from hematogenous spread have been reported [ 12 ]. Furthermore, Actinomyces sp.…”

Section: Introductionmentioning

confidence: 99%

A Case Report of Oral Bisphosphonate Treatment for Osteoporosis Leading to Atypical Femoral Fracture and Pathologic Mandibular Fracture

Fernandes,

Viezzer Fernandes,

Jitumori

et al. 2023

Am J Case Rep

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Patient: Female, 63-year-old Final Diagnosis: Atypical femoral fracture • medication-related osteonecrosis of the jaws • osteomyelitis of the femur pathologic mandibular fracture Symptoms: Chin hyperemia • intraoral suppuration • mandibular bone exposure Clinical Procedure: Antibiotics • debridement • dental implant removal • discontinue bisphosphonate • hyperbaric oxygen treatment • internal fixation • open reduction • sequestrectomy Specialty: Dentistry • Infectious Diseases • Orthopedics and Traumatology Objective: Rare coexistence of disease or pathology Background: Bisphosphonates inhibit bone resorption in patients with postmenopausal osteoporosis and reduce osteoporotic fracture incidence. Medication-related osteonecrosis of the jaws (MRONJ) and atypical femoral fractures (AFF) are both rare but serious adverse effects of anti-resorptive drugs (ARD) such as bisphosphonates. The most advanced form of MRONJ is termed stage 3 and can lead to severe local sequelae like pathologic mandibular fractures (PMF). This study reports a case of MRONJ-related PMF and AFF with osteomyelitis secondary to bisphosphonate treatment for osteoporosis. Case Report: A 63-year-old white woman was diagnosed with PMF related to MRONJ stage 3 during treatment of an AFF with osteomyelitis. She had been treated for postmenopausal osteoporosis with 70 mg of alendronate weekly for 2 years. The PMF was treated by stable internal fixation combined with debridement and sequestrectomy, but further debridement was required and 2 mandibular implants were then removed. Postoperative recovery was uneventful and the mandibular infection was controlled after the second surgery. Three weeks later, she was discharged from the hospital, instructed to discontinue the use of alendronate, and referred for 30 sessions of hyperbaric oxygen therapy. At the 3-year follow-up, the PMF was completely healed without signs of mandibular infection or bone exposure. Conclusions: This report raises awareness of both MRONJ and AFF as possible adverse effects of short-term bisphosphonate therapy for postmenopausal osteoporosis, and highlights the importance of dental and orthopedic follow-ups. It is crucial to emphasize the need for early diagnosis and treatment to prevent MRONJ progression to PMF.

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Actinomycotic osteomyelitis of a long bone in an immunocompetent adult: a case report and literature review

Cited by 6 publications

References 19 publications

Musculoskeletal actinomycosis in children: a case report

Musculoskeletal actinomycosis in children: a case report

An Actinomyces Long-Bone Osteomyelitis Case Report and Review

A Case Report of Oral Bisphosphonate Treatment for Osteoporosis Leading to Atypical Femoral Fracture and Pathologic Mandibular Fracture

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