Mycobacterium fortuitum osteomyelitis following trauma

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Hyperbaric Medicine

Background:

• Osteomyelitis is a serious bone infection, often following trauma.
• Mycobacterium fortuitum can cause challenging infections, particularly in orthopedic settings.
• Open fractures present a high risk for microbial contamination and subsequent infection.

Observation:

• A patient sustained an open fracture of the proximal humerus after a motor-vehicle accident.
• The fracture became infected with Mycobacterium fortuitum, a rapidly growing mycobacterium.
• The infection presented a significant challenge due to the nature of the pathogen and the fracture type.

Findings:

• A treatment regimen involving a single surgical debridement was implemented.
• Oral ciprofloxacin was administered as antibiotic therapy.
• Hyperbaric oxygen therapy was utilized as an adjunctive treatment modality.
• The patient achieved a disease-free state at the 2-year follow-up mark.

Implications:

• This case suggests that a combination of surgical intervention, targeted antibiotics, and hyperbaric oxygen may be effective for Mycobacterium fortuitum osteomyelitis.
• The findings highlight the importance of considering atypical mycobacteria in the differential diagnosis of post-traumatic osteomyelitis.
• Successful management of such infections can lead to favorable long-term outcomes and limb salvage.