Application of NGS Technology in Osteomyelitis Caused by Human Bites

Osteomyelitis caused by human bites is a severe and complex polymicrobial infection that is often complicated by delayed diagnosis and the high false-negative rate of conventional cultures. This case series retrospectively analyzed four cases of human bite-induced osteomyelitis to evaluate the clinical utility of next-generation sequencing (NGS) for the diagnosis of complex infections. Conventional intraoperative bacterial cultures were negative in two of the four cases, limiting pathogen-directed antimicrobial therapy. In contrast, NGS identified microbial organisms in all four patients and revealed polymicrobial profiles in several cases, including fastidious oral flora and obligate anaerobes that were not detected by conventional culture, such as Prevotella, Bacteroides, and Porphyromonas species, as well as Treponema denticola. All four patients achieved satisfactory wound healing without radiological evidence of recurrence, regained full range of motion, and returned to normal daily activities during follow-up. These findings support the potential value of NGS as an adjunctive diagnostic tool for identifying difficult-to-culture pathogens and providing additional microbiological information to support clinical decision-making in complex osteomyelitis.