Proteus Infection of the Spine

MultifocalProteus mirabilisosteomyelitis requiring bilateral amputation in an HIV-positive patient

“…Osteomyelitis caused by infection with Proteus mirabilis is rare, especially in adults. [1][2][3][4] The most common pathogen causing osteomyelitis in HIV carriers, as in the general population, is Staphylococcus aureus. 5,6 The only report referring to osteomyelitis caused by Proteus mirabilis in an HIVpositive patient is by Bahebeck et al 7 In their large series of 31 musculoskeletal infections in HIV-positive patients, Proteus mirabilis was the responsible organism in six.…”

“…No clear explanation can be given for the multifocal localisation and the extensive bone destruction. Previous reports have also mentioned marked bony destruction in cases of Proteus mirabilis osteomyelitis of the spine and the head of the humerus, 3,16 with local secretion of urease by the bacterium as a possible mechanism.…”

“…Osteomyelitis caused by infection with Proteus mirabilis is rare. [1][2][3][4] Its clinical course is unpredictable. To the best of our knowledge this is the first report of multifocal Proteus mirabilis osteomyelitis in an HIV carrier, as verified by repetitive cultures.…”

Spinal osteomyelitis caused by Proteus mirabilis in a child

“…mirabilis osteomyelitis is rare and most often seen in neonates and elderly. Spinal osteomyelitis due to P. mirabilis is not reported in children and the reason for the absence of patients in the 10-40 age group is unclear [5,7,8].…”

“…Spinal osteomyelitis caused by this organism has only been described in adults [4,7,8] and the urinary tract has been suggested as the focus of the infection [1,3,9].…”