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Bacteroides fragilis Acute Hematogenous Osteomyelitis in a Young Female with Sickle Cell Disease

Nada Bassam Hamieh1, Hiba Abdul Hamid Abou Layla1, Rola Ali Ali1

  • 1American University of Beirut Medical Center, Beirut, Lebanon.

Case Reports in Infectious Diseases
|December 13, 2023
PubMed

Insights

Sickle cell disease patients face higher infection risks. This report details the first case of osteomyelitis caused by Bacteroides fragilis in a sickle cell patient, highlighting a rare but critical pathogen.

Area of Science:

  • Infectious Diseases
  • Hematology
  • Orthopedic Surgery

Background:

  • Sickle cell disease (SCD) patients exhibit increased susceptibility to infections, with osteomyelitis being a significant complication.
  • Commonly implicated pathogens in SCD osteomyelitis include Salmonella spp. and Staphylococcus aureus.
  • Anaerobic bacterial involvement, particularly Bacteroides fragilis, is infrequently reported in this population.

Observation:

  • A 28-year-old female with SCD presented with acute tibial osteomyelitis.
  • Diagnosis was confirmed by isolating Bacteroides fragilis from blood and tibial fluid cultures.
  • The patient had a hematogenous osteomyelitis, indicating bloodstream seeding of the bone.

Findings:

  • This case represents the first documented instance of acute hematogenous tibial osteomyelitis caused by Bacteroides fragilis in a patient with sickle cell disease.
  • Successful management involved a combination of intravenous and oral antibiotics, alongside percutaneous drainage of the infected collection.
  • The patient demonstrated a positive clinical response to the prescribed treatment regimen.

Implications:

  • Highlights the potential role of Bacteroides fragilis as a causative agent of osteomyelitis in sickle cell disease patients, expanding the spectrum of known pathogens.
  • Emphasizes the need for considering anaerobic organisms in the differential diagnosis of osteomyelitis in SCD patients, even when less common.
  • May influence diagnostic approaches and antimicrobial treatment strategies for osteomyelitis in the SCD population, potentially improving patient outcomes.

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