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Bacteroides fragilis bacteremia associated with vertebral osteomyelitis in a sickle cell patient

Jaffar A Al-Tawfiq1

  • 1Internal Medicine Services Division, Dhahran Health Center, Saudi Aramco Medical Services Organization, Dhahran, Saudi Arabia. jaffar.tawfiq@aramco.com

Internal Medicine (Tokyo, Japan)
|December 17, 2008
PubMed

Insights

Sickle cell disease patients can develop serious bone infections. This case highlights a rare vertebral osteomyelitis caused by Bacteroides fragilis, successfully treated with antibiotics alone.

Area of Science:

  • Infectious Diseases
  • Hematology
  • Microbiology

Background:

  • Sickle cell disease (SCD) patients have a significantly higher risk of osteomyelitis (18%) and septic arthritis (7%).
  • Common pathogens include Salmonella spp. and Staphylococcus spp.; anaerobic infections are rare in SCD-related osteomyelitis.

Observation:

  • An 18-year-old female with SCD presented with suspected spontaneous vertebral osteomyelitis.
  • Blood cultures were positive for Bacteroides fragilis, an unusual cause of osteomyelitis in this population.

Findings:

  • The diagnosis of vertebral osteomyelitis was confirmed through positive blood cultures.
  • The source of infection could not be identified despite thorough investigation.
  • The patient received a four-week course of metronidazole, an antibiotic effective against anaerobic bacteria.

Implications:

  • This case underscores the possibility of anaerobic bacterial infections, such as Bacteroides fragilis, in sickle cell disease patients with osteomyelitis.
  • Prompt antibiotic therapy with metronidazole can be effective in treating such infections, potentially avoiding surgical intervention.
  • Highlights the importance of considering a broader range of pathogens in SCD-related bone infections.

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