Acute hematogenous osteomyelitis of a closed fracture with chronic superinfection.
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.
Aluisio
F V
FV
Division of Orthopaedic Surgery, Duke University Medical Center, Durham, NC 27710, USA.
Scully
S P
SP
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*