Vertebral osteomyelitis due to species: report of three cases and review of the literature

BackgroundFusobacterium 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 presentationA 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.ConclusionsClinicians should be aware that F. nucleatum could be the etiologic agent of hematogenous osteomyelitis of a long bone in an immunocompetent patient.

show abstract

“…The species most commonly isolated is F. necrophorum [6,7,11]. Cases of F. nucleatum are relatively rare [1,9].…”

Section: Discussionmentioning

confidence: 99%

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

Lee

Park

et al. 2012

BMC Infect Dis

View full text Add to dashboard Cite

show abstract

“…Seven of the reviewed cases [ 10, 12, 19, 21 ] utilised blood cultures for identification of causative organisms. The yield from blood cultures can range from 40–60 % in haematogenous pyogenic spondylodiscitis [ 22 ], and there have been reports of polymicrobial infections being missed when blood culture sampling is the only microbiological investigation [ 23 ].…”

Section: Discussionmentioning

confidence: 99%

A case of polymicrobial anaerobic spondylodiscitis due to Parvimonas micra and Fusobacterium nucleatum

et al. 2017

View full text Add to dashboard Cite

Introduction. Here, we present a case of polymicrobial anaerobic spondylodiscitis. Case Presentation. A forty-five year-old female patient was referred to a specialist orthopaedic hospital with an eight week history of back pain without fevers. X-ray imaging and magnetic resonance imaging showed acute osteomyelitis of the twelfth thoracic and first lumbar vertebrae. Prolonged enrichment cultures grew Parvimonas micra and Fusobacterium nucleatum, identified by matrix-assisted laser desorption ionisation-time of flight (MALDI-ToF) mass spectrometry (MS). The patient was successfully treated with six weeks of intravenous ertapenem and oral clindamycin. Conclusion. Anaerobic discitis is rare, and polymicrobial discitis is rarer still. A PubMed literature review revealed only seven cases of F. nucleatum discitis and only twelve cases of P. micra discitis; this includes only one other reported case of a polymicrobial discitis due to infection with both anaerobes. We emphasise the importance of prolonging enrichment culture and the use of fast yet accurate identification of anaerobes using MALDI-ToF MS in these infections.

show abstract

“…The monomicrobial causes of emphysematous osteomyelitis are similar to causes of other gas-forming infections, which include E. coli, Klebsiella pneumoniae, Enterobacter aerogenes, and Clostridium spp . [191011]. In cases of post-surgical infections, gram-positive organisms such as Staphylococcus aureus, non-hemolytic streptococci, and enterococci, and Pseudomonas spp.…”

Section: Discussionmentioning

confidence: 99%

Emphysematous Osteomyelitis due to Escherichia coli

et al. 2017

View full text Add to dashboard Cite

Vertebral osteomyelitis due to species: report of three cases and review of the literature

Cited by 35 publications

References 18 publications

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

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

A case of polymicrobial anaerobic spondylodiscitis due to Parvimonas micra and Fusobacterium nucleatum

Emphysematous Osteomyelitis due to Escherichia coli

Contact Info

Product

Resources

About