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Fusobacterium osteomyelitis in a child with sickle cell disease
Sandra J Murray1, Jay M Lieberman
1Division of Pediatric Infectious Diseases, Department of Pediatrics Miller Children's Hospital Long Beach, CA, USA.
Insights
Children with sickle cell disease face a higher risk of osteomyelitis. A rare case of anaerobic osteomyelitis caused by Fusobacterium nucleatum was successfully treated with surgery and hyperbaric oxygen therapy.
Area of Science:
- Pediatric infectious diseases
- Bone infections
- Microbiology
Background:
- Children with sickle cell disease (SCD) have an increased susceptibility to osteomyelitis.
- Common causative agents include Salmonella spp. and Staphylococcus aureus.
- Anaerobic bacterial infections are less common but can occur in SCD patients.
Observation:
- A pediatric case of osteomyelitis caused by Fusobacterium nucleatum, an anaerobic bacterium, in a child with SCD is presented.
- The patient's infection was refractory to antibiotic treatment alone.
- This highlights a potential, less-common pathogen in SCD-related bone infections.
Findings:
- Fusobacterium nucleatum can cause anaerobic osteomyelitis in children with sickle cell disease.
- Antibiotic therapy alone was insufficient for treatment.
- Combined surgical debridement and hyperbaric oxygen therapy (HBOT) led to a cure.
Implications:
- Highlights the importance of considering anaerobic pathogens in osteomyelitis, especially in immunocompromised children like those with SCD.
- Suggests that a multimodal treatment approach including surgical intervention and HBOT may be necessary for refractory cases.
- Expands understanding of infectious complications in sickle cell disease, emphasizing diverse etiologies and treatment strategies.
Abstract:
Children who have sickle cell disease are at increased risk for osteomyelitis caused by Salmonella spp. and Staphylococcus aureus. We report a case of anaerobic osteomyelitis caused by Fusobacterium nucleatum in a child with sickle cell disease. The infection did not resolve with antibiotic therapy alone, but was cured after surgical debridement and hyperbaric oxygen therapy.