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Diphtheroid osteomyelitis.

B F Morrey, R H Fitzgerald, P J Kelly

    The Journal of Bone and Joint Surgery. American Volume
    |June 1, 1977
    PubMed
    Summary
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    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.

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  • 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.