Acute staphylococcal hind foot osteomyelitis in a healthy adult: A case report.
BACKGROUND
Acute osteomyelitis of the hind foot is uncommon in a normal immunocompetent adult.


METHODS
We present a previously healthy 52 year old caucasian male who developed painful swelling of his ankle/hindfoot following closed soft tissue football injury. He had no antecedent systemic symptoms. Magnetic resonance imaging and bone scan imaging, followed by surgical decompression and bone biopsy confirmed a diagnosis of Staphylococcus aureus hind foot osteomyelitis. He underwent triple fusion after debridement and had suppressive antibiotics. His pain and swelling resolved at 6 weeks postoperation and CT confirmed fusion at 6 months. His inflammatory markers normalised over the course of 7 months. After 18 months, he remained asymptomatic without any evidence of recurrence.


CONCLUSIONS
This case represents an unusual and important variation of presentation of acute osteomyelitis in a healthy adult. It can be easily overlooked when a normal patient presents with pain and functional impairment after a closed soft tissue trauma, but a high index of suspicion is paramount because virulent organisms can infect immunologically normal patients.
Department of Orthopaedics, Medway Foundation NHS Trust, Gillingham, Kent, United Kingdom. odaiyenuro@yahoo.com
Olusegun
O
Aiyenuro
Sajid
S
Shariff
D000208:Acute Disease; D000843:Ankle Joint; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D001706:Biopsy; D003646:Debridement / Q000379:methods*; D003937:Diagnosis, Differential; D005500:Follow-Up Studies; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D019637:Orthopedic Procedures / Q000379:methods*; D010019:Osteomyelitis / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D013203:Staphylococcal Infections / Q000175:diagnosis* / Q000382:microbiology / Q000628:therapy; D013211:Staphylococcus aureus / Q000302:isolation & purification*; D014057:Tomography, X-Ray Computed
D000900:Anti-Bacterial Agents