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Primary osteomyelitis caused by coagulase-negative staphylococci
Abstract:
Coagulase-negative staphylococci (CONS) are occasionally cultured from foci of osteomyelitis in otherwise healthy individuals and are usually regarded as contaminants. The present report describes two children with subacute osteomyelitis of the distal tibia in which pure cultures of CONS were obtained from bone. In one patient, the infection was multifocal, and CONS were isolated from two anatomical sites at two different times. In the other patient, the infection was unifocal, and CONS were cultured from two separate specimens obtained from the same site. In both patients, the symptoms progressed until appropriate antibiotic treatment was initiated. CONS isolated from cultures of bone should not automatically be disregarded. Appropriate antibiotic therapy may result in clinical resolution.
Insights
Coagulase-negative staphylococci (CONS) can cause subacute osteomyelitis in children. These bacteria, often dismissed as contaminants, require appropriate antibiotic treatment for resolution.
Area of Science:
- Pediatric Infectious Diseases
- Orthopedic Surgery
- Microbiology
Background:
- Coagulase-negative staphylococci (CONS) are typically considered contaminants in bone infections.
- Subacute osteomyelitis is a bone infection that develops gradually.
Observation:
- This report details two pediatric cases of subacute osteomyelitis of the distal tibia.
- Pure cultures of CONS were isolated from bone in both patients.
- Infection was multifocal in one patient and unifocal in the other, with CONS isolated from multiple samples.
Findings:
- CONS were the causative agents of osteomyelitis in these two children.
- Symptoms persisted until targeted antibiotic therapy was administered.
- Both patients showed clinical improvement following appropriate antibiotic treatment.
Implications:
- CONS should not be automatically disregarded as mere contaminants in osteomyelitis cases.
- Accurate identification and susceptibility testing of CONS are crucial for effective treatment.
- Prompt and appropriate antibiotic therapy can lead to successful clinical resolution of CONS-induced osteomyelitis.