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Acute hematogenous osteomyelitis in intravenous drug users

I M Fox1, K Brady

  • 1UMDNI/Robert Wood Johnson Medical School, Camden, USA.

The Journal of Foot and Ankle Surgery : Official Publication of the American College of Foot and Ankle Surgeons
|July 1, 1997
PubMed

Insights

Acute hematogenous osteomyelitis developed in an adult intravenous drug user with a metatarsal fracture. Staphylococcus aureus bacteremia likely seeded the fracture, leading to infection and significant morbidity.

Area of Science:

  • Orthopedics
  • Infectious Diseases
  • Medical Case Study

Background:

  • Hematogenous osteomyelitis is a bone infection that can occur via bloodstream seeding.
  • Intravenous drug use is a known risk factor for Staphylococcus aureus bacteremia and subsequent infections.

Observation:

  • A case of acute hematogenous osteomyelitis is presented in an adult with a closed metatarsal fracture.
  • The patient was an intravenous drug user, and Staphylococcus aureus bacteremia was identified via blood cultures.

Findings:

  • The Staphylococcus aureus bacteremia is presumed to have seeded the pre-existing metatarsal fracture.
  • Osteomyelitis was confirmed by intraoperative cultures matching blood cultures and a Technetium-HMPAO-labeled leukocyte scan.
  • Patient noncompliance and delayed information sharing potentially contributed to increased morbidity.

Implications:

  • This case highlights the risk of osteomyelitis in intravenous drug users with fractures.
  • Early recognition and management are crucial to prevent severe outcomes.
  • A critical review of patient management strategies in this population is warranted.

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