Multifocal Proteus mirabilis osteomyelitis requiring bilateral amputation in an HIV-positive patient

Area of Science:

• Infectious Diseases
• Orthopedic Surgery
• Immunology

Background:

• Osteomyelitis, a bone infection, can be caused by various bacteria.
• Proteus mirabilis is a Gram-negative bacterium known for causing urinary tract infections and sometimes other infections.
• Human Immunodeficiency Virus (HIV) infection can impact immune status and susceptibility to infections.

Observation:

• A rare case of multifocal osteomyelitis caused by Proteus mirabilis in an HIV-positive patient is described.
• The patient presented with a severe infection despite having a good CD4 cell count, indicating relatively preserved immune function.
• The infection was aggressive and difficult to manage, requiring extensive treatment.

Findings:

• Despite aggressive treatment protocols, the multifocal Proteus mirabilis osteomyelitis persisted.
• The infection ultimately led to a severe outcome, necessitating bilateral above-knee amputations.
• This case highlights the unpredictable clinical course of Proteus mirabilis osteomyelitis in immunocompromised individuals.

Implications:

• Multifocal Proteus mirabilis osteomyelitis requires careful consideration in HIV-positive patients, even with good immune status.
• Aggressive treatment may not always be sufficient to prevent severe complications and limb loss.
• This case underscores the need for vigilant monitoring and potentially novel therapeutic strategies for managing severe bone infections in HIV patients.