title: Genotyping and Resolution of a Case of Osteomyelitis in a 16-Month-Old Boy of Hispanic/African American Ethnicity.
abstract: Most cases of osteomyelitis in children are caused by Staphylococcus aureus, although Kingella kingae, various streptococci, and Salmonella species also underlie this condition. Organisms such as Mycobacterium, Histoplasma, and Cryptococcus are much less commonly identified as etiologic agents in osteomyelitis. This case report describes a 16-month-old boy of Hispanic/African American ethnicity who had extensive inflammation of and discharge from his right ankle. Imaging studies supported a diagnosis of osteomyelitis. Acid-fast bacillus (AFB) and routine wound cultures were ordered on the wound discharge. The AFB culture yielded a positive result for Mycobacterium bovis, and molecular diagnostic testing further genotyped the microorganism as Mycobacterium bovis, Bacillus Calmette-Guerin (BCG). Herein, we report a rare case of osteomyelitis that we believe resulted from a BCG vaccine that the patient had received outside the United States.
authors.affiliation: Departments of Clinical Laboratory Science, Tarleton State University, Fort Worth, TX.
authors.forename: Eunice
authors.initials: E
authors.lastname: Wachira
authors.affiliation: Departments of Clinical Laboratory Science, Tarleton State University, Fort Worth, TX.
authors.forename: Kayla
authors.initials: K
authors.lastname: Tran
authors.affiliation: Departments of Clinical Laboratory Science, Tarleton State University, Fort Worth, TX, sataylor@tarleton.edu.
authors.forename: Sara
authors.initials: S
authors.lastname: Taylor
authors.affiliation: Departments of Clinical Laboratory Science, Tarleton State University, Fort Worth, TX.
authors.forename: Sally
authors.initials: S
authors.lastname: Hoger
authors.affiliation: Departments of Pathology & Immunology, Baylor College of Medicine, Houston, TX, and Departments of Pathology, Texas Children's Hospital, Houston, TX.
authors.forename: James
authors.initials: J
authors.lastname: Dunn
mesh_terms: D001741:Black or African American; D000842:Ankle / Q000473:pathology*; D060005:Genotyping Techniques; D006630:Hispanic or Latino; D006801:Humans; D007223:Infant; D008297:Male; D009163:Mycobacterium bovis / Q000145:classification / Q000235:genetics / Q000302:isolation & purification*; D010019:Osteomyelitis / Q000175:diagnosis* / Q000382:microbiology; D014376:Tuberculosis / Q000175:diagnosis* / Q000382:microbiology
keywords: Bacillus Calmette-Guerin (BCG); Mycobacterium bovis; Region of Difference; molecular diagnostic testing; osteomyelitis; spoligotype