title: Aggregatibacter actinomycetemcomitans osteomyelitis in a 12 year old boy: case report emphasizing the importance of tissue culture, and review of literature.
abstract: BACKGROUND
  Aggregatibacter actinomycetemcomitans most commonly causes periodontitis but has been reported to infect heart valves, soft tissue, brain and lungs, and distal bones. Osteomyelitis distal to the jaw is rarely described.
  
  
  METHODS
  We report an unusual and rare case of chronic osteomyelitis caused by A. actinomycetemcomitans in the toe of a paediatric patient, and review the available literature. The infection was managed with intravenous antibiotics followed by oral antibiotics.
  
  
  CONCLUSIONS
  This is an unusual presentation of A. actinomycetemcomitans causing chronic osteomyelitis presumed due to nidation in a minimally damaged bone, associated with bacteraemia of an oral commensal. It occurred in the toe, without obvious dental predisposition; associated with minimal clinical disturbance and with muted immune response.
authors.affiliation: Department of Paediatrics, School of Medicine, Western Sydney University, Sydney, NSW, Australia.
authors.forename: Ketaki
authors.initials: K
authors.lastname: Sharma
authors.affiliation: Department of Paediatrics, School of Medicine, Western Sydney University, Sydney, NSW, Australia. p.mudgil@westernsydney.edu.au.
authors.forename: Poonam
authors.initials: P
authors.lastname: Mudgil
authors.affiliation: Department of Paediatrics, School of Medicine, Western Sydney University, Sydney, NSW, Australia.
authors.forename: John S
authors.initials: JS
authors.lastname: Whitehall
authors.affiliation: Department of Infectious Diseases and Microbiology, School of Medicine, Western Sydney University, Sydney, NSW, Australia.
authors.forename: Iain
authors.initials: I
authors.lastname: Gosbell
mesh_terms: D016976:Aggregatibacter actinomycetemcomitans / Q000302:isolation & purification / Q000472:pathogenicity*; D000658:Amoxicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D016470:Bacteremia / Q000188:drug therapy*; D002439:Cefotaxime / Q000627:therapeutic use; D002648:Child; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D010019:Osteomyelitis / Q000188:drug therapy* / Q000382:microbiology*; D014034:Toes / Q000382:microbiology* / Q000473:pathology
chemical_list: D000900:Anti-Bacterial Agents; D000658:Amoxicillin; D002439:Cefotaxime