Streptococcus pneumoniae Osteomyelitis in a 25-Year-Old Man as the Initial Presentation of Multiple Myeloma: A Case
Tracy Webber1, Michael Lawlor2, Tessa Balach3
1Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut.
Case:
We report the case of a 25-year-old man with femoral Streptococcus pneumoniae pyomyositis as well as hypercalcemia, mild anemia, and elevated inflammatory markers; he subsequently was diagnosed with immunoglobulin G (IgG) kappa multiple myeloma.
Conclusion:
Multiple myeloma most commonly affects patients who are >60 years of age, and causes clinical symptoms from anemia, lytic bone lesions, hypercalcemia, and renal failure. These findings and a monoclonal protein spike serve as initial diagnostic and treatment criteria. Multiple myeloma is associated with susceptibility to bacterial infections, especially encapsulated organisms; however, this is rarely the initial presentation. Additionally, it is unusual for myeloma to be diagnosed in a young person (<40 years of age).
