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Needle licker's osteomyelitis
L A Swisher1, J R Roberts, M J Glynn
1Department of Emergency Medicine, Mercy Catholic Medical Center, Philadelphia, PA.
The American Journal of Emergency Medicine
|May 1, 1994
Summary
Eikenella corrodens, a bacteria found in saliva, can cause severe bone and joint infections, particularly in intravenous drug users. This case highlights a rare link between E. corrodens, i.v. drug use, and septic arthritis with osteomyelitis.
Area of Science:
- Infectious Diseases
- Microbiology
- Orthopedics
Background:
- Eikenella corrodens is a gram-negative bacillus commonly found in human saliva.
- It is often associated with infections resulting from human bites and head/neck trauma.
- Previous literature documented E. corrodens infections primarily in intravenous drug users, but without bone or joint involvement.
Observation:
- An unusual case of mixed flora septic arthritis and osteomyelitis caused by E. corrodens and Streptococcus is presented.
- The infection originated from saliva contamination after licking an intravenous needle.
- This represents a novel presentation of E. corrodens infection in an intravenous drug user.
Findings:
- The case details the microbiology and unique antibiotic sensitivity of the isolated E. corrodens strain.
- This is the first reported instance linking E. corrodens to septic arthritis and osteomyelitis in the context of intravenous drug use.
- The study emphasizes the potential for severe skeletal infections from this pathogen in this patient population.
Implications:
- Highlights a previously unrecognized complication of intravenous drug use involving E. corrodens.
- Suggests the need for increased awareness of E. corrodens as a causative agent in septic arthritis and osteomyelitis, especially in i.v. drug users.
- Recommends specific antibiotic treatments, including penicillin, ampicillin, or tetracycline for penicillin-allergic patients.