title: Acute hematogenous osteomyelitis of a closed fracture with chronic superinfection.
abstract: Acute hematogenous salmonella osteomyelitis is rare among immunocompetent adults. In this study, the authors reported an unusual case of salmonella enteriditis osteomyelitis of the humerus complicated by methicillin-resistant Staphylococcus aureus superinfection and eventual chronic osteomyelitis in an immunocompetent host. Resection of the humeral head and a significant portion of the humeral shaft coupled with numerous surgical debridements and intravenously administered antibiotics led to resolution of symptoms. This case provides a rare example of acute hematogenous osteomyelitis complicating a closed fracture and demonstrates the difficulty associated with eradication of these specific organisms while emphasizing the principle of aggressive surgical debridement in cases of chronic osteomyelitis.
authors.affiliation: Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: F V
authors.initials: FV
authors.lastname: Aluisio
authors.forename: S P
authors.initials: SP
authors.lastname: Scully
mesh_terms: D000208:Acute Disease; D016470:Bacteremia / Q000209:etiology* / Q000382:microbiology; D002908:Chronic Disease; D003924:Diabetes Mellitus, Type 2 / Q000150:complications; D005596:Fractures, Closed / Q000150:complications*; D006801:Humans; D006810:Humeral Fractures / Q000150:complications*; D016867:Immunocompromised Host; D016106:Methicillin Resistance; D008875:Middle Aged; D010019:Osteomyelitis / Q000209:etiology* / Q000382:microbiology; D012480:Salmonella Infections / Q000209:etiology*; D012477:Salmonella enteritidis; D013203:Staphylococcal Infections / Q000209:etiology*; D013211:Staphylococcus aureus; D015163:Superinfection / Q000209:etiology*