Reciprocal hematogenous osteomyelitis of the femurs caused by Anaerococcus prevotii:A case report

查看全文 作　　者：Karolina [1]Daunaraite;Valentinas [2]Uvarovas;Donatas [3]Ulevicius;Tomas [2]Sveikata;Giedrius [2]Petryla;[2]JauniusKurtinaitis;Igoris [2]Satkauskas 机构地区：[1]Vilnius University,Institute of Clinical Medicine,Faculty of Medicine,Vilnius LT-08661,Lithuania;[2]Department of Orthopedics and Traumatology,Institute of Clinical Medicine,Faculty of Medicine,Vilnius University,Vilnius LT-08661,Lithuania;[3]Department of Orthopedics and Traumatology,Vilnius LT-04130,Lithuania 出　　处：《World Journal of Clinical Cases》索引2021年第9卷第4期,共8页 摘　　要：BACKGROUND Haematogenous osteomyelitis is an extremely rare disease occurring in adults,especially in developed countries.It is clearly a systemic infection,because bacteraemia spreads over proximal and distal long bones or paravertebral plexuses,resulting in acute or chronic bone infection and destruction.CASE SUMMARY A 46-year-old Caucasian male was complaining of a left thigh pain.It is known from the anamnesis that the patient developed severe pneumonia three months ago before the onset of these symptoms.The patient was diagnosed with haematogenous osteomyelitis,which developed a turbulent course and required complex combination therapy.The primary pathogen is thought to be Anaerococcus prevotii,which caused pneumonia before the onset of signs of osteomyelitis.Unfortunately,due to the complexity of identifying anaerobes and contributing nosocomial infections,the primary pathogen was not extracted immediately.After the manifestation of this disease,pathological fractures occurred in both femurs,as well as purulent processes in the lungs and molars accompanied.The patient received broad-spectrum antibiotic therapy and countless amounts of orthopaedic and reconstructive surgeries,but no positive effect was observed.The patient underwent osteosynthesis using an Ilizarov’s external fixation apparatus,re-fixations,external AO,debridements,intramedullary osteosynthesis with a silver-coated intramedullary nail,abscessotomies.The right femur healed completely after the pathological fracture and osteomyelitis did not recur.Left femur could not be saved due to non-healing,knee contracture and bone destruction.After almost three years of struggle,it was decided to amputate the left limb,after which the signs of osteomyelitis no longer appeared.CONCLUSION To sum it all up,complicated or chronic osteomyelitis requires surgery to remove the infected tissue and bone.Osteomyelitis surgery prevents the infection from spreading further or getting even worse up to such condition that amputation is the only option left. 关 键 词：HEMATOGENOUS Femur osteomyelitis Reciprocal Pathologic fracture Anaeroccocus prevotii Case report