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Fusobacterium osteomyelitis associated with intraosseous gas
G D Foulkes1, C E Johnson, H P Katner
1Department of Surgery, Mercer University School of Medicine, Macon, Georgia.
Clinical Orthopaedics and Related Research
|February 1, 1990
Summary
This study reports a rare case of acute anaerobic osteomyelitis caused by Fusobacterium necrophorum in a diabetic patient. The infection presented with intraosseous gas and was successfully treated with antibiotics and surgery.
Area of Science:
- Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Osteomyelitis, particularly anaerobic forms, is a challenging infection.
- Fusobacterium necrophorum is an uncommon pathogen in osteomyelitis, typically associated with oropharyngeal or gastrointestinal infections.
- Intraosseous gas is an unusual finding in osteomyelitis, often associated with gas-forming organisms.
Observation:
- A 57-year-old hypertensive, diabetic female presented with groin pain and fever.
- Imaging revealed intraosseous gas in the right femoral head and surrounding soft tissue.
- Biopsy cultures identified Fusobacterium necrophorum as the causative anaerobic gram-negative bacillus.
Findings:
- The patient received metronidazole and underwent debridement, drainage, and Girdlestone arthroplasty.
- Treatment led to resolution of infection, with the patient afebrile and ambulatory at discharge.
- This represents a unique case of Fusobacterium necrophorum osteomyelitis with intraosseous gas, previously unreported.
Implications:
- Highlights the potential for Fusobacterium necrophorum to cause severe bone infections, even in the absence of typical risk factors.
- Emphasizes the importance of considering anaerobic pathogens and intraosseous gas in the differential diagnosis of osteomyelitis.
- Suggests that prompt diagnosis and appropriate antimicrobial therapy, alongside surgical intervention, are crucial for favorable outcomes in complex osteomyelitis cases.
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