Olgu Sunumu
Yıl 2016,
Cilt: 21 Sayı: 2, 143 - 148, 30.04.2016
Öz
Osteomiyelite yol açan patojenler çeşitlilik göstermekle birlikte, bağışıklığı baskılanmış hastalardadaha nadir görülen mikroorganizmalar da etken olabilmektedir. Bu çalışmada nadir bir vakaolarak, Fusobacterium cinsi bir bakterinin sebep olduğu osteomiyelitten muzdarip bir hastanıntanı ve tedavisini sunmayı amaçladık.
48 yaşındaki kadın hasta sol uyluğunda üç aydır mevcut olan ağrı ve şişlik şikayetiyle bize başvurdu.Çekilmiş olan MR görüntülerine göre malign kemik tümörü ön tanısı alarak kliniğimize sevkedilmişti. Hastanın skleroderma nedeniyle immünosüpresif ilaç kullanma hikayesi mevcuttu. İlkbaşvurudan iki gün sonra patolojik femur kırığı geçiren hastaya osteomiyelitin cerrahi tedavisiolarak apse drenajı, debridman ve kırık için de antibiyotikli sement kaplı intramedüller çivi ile osteosentezameliyatı yapıldı. Ameliyat öncesinde alınan örneklerin kültüründe Fusobacterium necrophorumüredi. Yatışı sırasında vakum yardımlı kapama ile takip edilen hasta, akut faz reaktanlarınormale döndükten ve IV antibiyotik tedavisi tamamlandıktan sonra taburcu edildi.İmmün sistemi baskılanmış hastalarda Fusobacterium cinsi bakterilerin osteomiyelit etkeni olabileceğive kemikteki litik lezyonların ayırıcı tanısında osteomiyelit olasılığı akılda tutulmalıdır.
Anahtar Kelimeler
Kaynakça
- Lewis RP, Sutter VL, Finegold SM. Bone infections involving anaerobic bacteria. Medicine. 1978;57(4):279– 305.
- Hatzenbuehler J, Pulling TJ. Diagnosis and management of osteomyelitis. Am Fam Physician. 2011;84(9):1027– 33.
- Bolstad AI, Jensen HB, Bakken V. Taxonomy, biology, and periodontal aspects of Fusobacterium nucleatum. Clin Microbiol Rev. 1996;9(1):55–71.
- Huggan PJ, Murdoch DR. Fusobacterial infections: clinical spectrum and incidence of invasive disease. J Infect. 2008;57(4):283–9.
- Goldberg EA, Venkat-Ramani T, Hewit M, Bonilla HF. Epidemiology and clinical outcomes of patients with Fusobacterium bacteraemia. Epidemiol Infect. 2013;141(2):325–9.
- Citron DM. Update on the taxonomy and clinical aspects of the genus fusobacterium. Clin Infect Dis. 2002;35(Suppl 1):S22–7.
- Creemers-Schild D, Gronthoud F, Spanjaard L, Visser LG, Brouwer CNM, Kuijper EJ. Fusobacterium necrophorum, an emerging pathogen of otogenic and paranasal infections? New Microbes New Infect. 2014;2(3):52–7.
- Latta TN, Mandapat AL, Myers JP. Anaerobic spondylodiscitis due to Fusobacterium Species: a case report review of the literature. Case Rep Infect Dis. 2015;2015:759539.
- Le Monnier A, Jamet A, Carbonnelle E, Barthod G, Moumile K, Lesage F, et al. Fusobacterium necrophorum middle ear infections in children and related complications: report of 25 cases and literature review. Pediatr Infect Dis J 2008;27(7):613–7.
- Carek PJ, Dickerson LM, Sack JL. Diagnosis and management of osteomyelitis. Am Fam Physician. 2001;63(12):2413–20 (Erratum: Am Fam Physician 2002;65(9):1751).
- Thonse R, Conway JD. Antibiotic cement-coated nails for the treatment of infected nonunions and segmental bone defects. J Bone Joint Surg Am. 2008;90 (Suppl 4):163–74.
- Chou DT, Pullinger M, Davis B. A method of fabricating an antibiotic cement spacer using an elastic nail for the treatment of intramedullary osteomyelitis.Ann R Coll Surg Engl. 2015;97(2):157–8.
- Nizegorodcew T, Palmieri G, Marzetti E. Antibioticcoated nails in orthopedic and trauma surgery: state of the art. Int J Immunopathol Pharmacol. 2011;24(1 Suppl 2):125–8.
- Brook I. Microbiology and management of joint and bone infections due to anaerobic bacteria. J Orthop Sci. 2008;13(2):160–9.
Yıl 2016,
Cilt: 21 Sayı: 2, 143 - 148, 30.04.2016
Öz
Although pathogens causing osteomyelitis vary, relatively uncommon microorganisms can cause osteomyelitis in immunosuppressed patients. In this study we aimed to present the diagnosis and treatment of a patient with a rare case of osteomyelitis due to infection with a species of Fusobacterium.
A 48-year-old female patient complaining of swelling and pain in her left thigh for the last three months was referred to our clinic with a prediagnosis of bone malignancy based on the MRI findings. The patient had a history of immunosuppressive drug use for scleroderma. The patient suffered a pathological femoral fracture two days after her first visit to us. Abscess drainage and debridement were performed to treat her osteomyelitis, and an osteosynthesis including antibiotic cement-coated intramedullary nail insertion was performed for the fracture. Fusobacterium necrophorum grew in the culture of the preoperative specimens. The patient for whom vacuum-assisted closure was used during her hospitalization was discharged after the acute phase reactants returned to normal and the IV antibiotic treatment was completed. It should be noted that bacteria from the genus Fusobacterium can cause osteomyelitis in immunosuppressed patients, and that while making the differential diagnosis of the lytic lesions of bones osteomyelitis is one of the possibilities.
Anahtar Kelimeler
Kaynakça
- Lewis RP, Sutter VL, Finegold SM. Bone infections involving anaerobic bacteria. Medicine. 1978;57(4):279– 305.
- Hatzenbuehler J, Pulling TJ. Diagnosis and management of osteomyelitis. Am Fam Physician. 2011;84(9):1027– 33.
- Bolstad AI, Jensen HB, Bakken V. Taxonomy, biology, and periodontal aspects of Fusobacterium nucleatum. Clin Microbiol Rev. 1996;9(1):55–71.
- Huggan PJ, Murdoch DR. Fusobacterial infections: clinical spectrum and incidence of invasive disease. J Infect. 2008;57(4):283–9.
- Goldberg EA, Venkat-Ramani T, Hewit M, Bonilla HF. Epidemiology and clinical outcomes of patients with Fusobacterium bacteraemia. Epidemiol Infect. 2013;141(2):325–9.
- Citron DM. Update on the taxonomy and clinical aspects of the genus fusobacterium. Clin Infect Dis. 2002;35(Suppl 1):S22–7.
- Creemers-Schild D, Gronthoud F, Spanjaard L, Visser LG, Brouwer CNM, Kuijper EJ. Fusobacterium necrophorum, an emerging pathogen of otogenic and paranasal infections? New Microbes New Infect. 2014;2(3):52–7.
- Latta TN, Mandapat AL, Myers JP. Anaerobic spondylodiscitis due to Fusobacterium Species: a case report review of the literature. Case Rep Infect Dis. 2015;2015:759539.
- Le Monnier A, Jamet A, Carbonnelle E, Barthod G, Moumile K, Lesage F, et al. Fusobacterium necrophorum middle ear infections in children and related complications: report of 25 cases and literature review. Pediatr Infect Dis J 2008;27(7):613–7.
- Carek PJ, Dickerson LM, Sack JL. Diagnosis and management of osteomyelitis. Am Fam Physician. 2001;63(12):2413–20 (Erratum: Am Fam Physician 2002;65(9):1751).
- Thonse R, Conway JD. Antibiotic cement-coated nails for the treatment of infected nonunions and segmental bone defects. J Bone Joint Surg Am. 2008;90 (Suppl 4):163–74.
- Chou DT, Pullinger M, Davis B. A method of fabricating an antibiotic cement spacer using an elastic nail for the treatment of intramedullary osteomyelitis.Ann R Coll Surg Engl. 2015;97(2):157–8.
- Nizegorodcew T, Palmieri G, Marzetti E. Antibioticcoated nails in orthopedic and trauma surgery: state of the art. Int J Immunopathol Pharmacol. 2011;24(1 Suppl 2):125–8.
- Brook I. Microbiology and management of joint and bone infections due to anaerobic bacteria. J Orthop Sci. 2008;13(2):160–9.
Toplam 14 adet kaynakça vardır.
Ayrıntılar
| Konular | Sağlık Kurumları Yönetimi |
|---|---|
| Bölüm | OLGU SUNUMU |
| Yazarlar | |
| Yayımlanma Tarihi | 30 Nisan 2016 |
| Kabul Tarihi | 6 Şubat 2016 |
| Yayımlandığı Sayı | Yıl 2016 Cilt: 21 Sayı: 2 |
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