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Diphtheroid osteomyelitis
Abstract:
Isolates of either Corynebacterium diphtheriae or Propionibacterium acnes from osteomyelitis are not necessarily contaminants, as shown by the cases of three patients who had bone and joint infections in which these organisms were pathogenic (one in pure culture and two in mixed cultures). Previous operation or other factors that compromise host resistance create the setting for these opportunistic organisms. Penicillin with or without streptomycin is the treatment of choice, but if penicillin or streptomycin cannot be used then the cephalosporins, clindamycin, and erythromycin are acceptable alternatives (depending on susceptibility studies). In general, the prognosis is good.
Insights
Corynebacterium diphtheriae and Propionibacterium acnes can cause bone infections, not just contamination. Prompt diagnosis and appropriate antibiotics, like penicillin, lead to good outcomes for osteomyelitis patients.
Area of Science:
- Infectious Diseases
- Orthopedics
- Microbiology
Background:
- Osteomyelitis is a bone infection often caused by common bacteria.
- Certain bacteria, like Corynebacterium diphtheriae and Propionibacterium acnes, may be overlooked as contaminants in bone infections.
- Compromised host resistance, often due to prior surgery, predisposes patients to opportunistic infections.
Purpose of the Study:
- To highlight that Corynebacterium diphtheriae and Propionibacterium acnes can be pathogenic causes of osteomyelitis.
- To emphasize the importance of considering these organisms in bone and joint infections.
- To review appropriate treatment and prognosis for infections caused by these bacteria.
Main Methods:
- Case study analysis of three patients with bone and joint infections.
- Identification of Corynebacterium diphtheriae and Propionibacterium acnes in patient isolates.
- Review of clinical presentation, treatment, and outcomes.
Main Results:
- Demonstrated pathogenicity of Corynebacterium diphtheriae and Propionibacterium acnes in three osteomyelitis cases (one pure culture, two mixed).
- Identified predisposing factors such as previous surgery and compromised host resistance.
- Confirmed good prognosis with appropriate antibiotic therapy.
Conclusions:
- Corynebacterium diphtheriae and Propionibacterium acnes should not be dismissed as contaminants in osteomyelitis.
- Penicillin, with or without streptomycin, is the preferred treatment.
- Alternative antibiotics include cephalosporins, clindamycin, and erythromycin based on susceptibility testing.