Uzun Kemik Osteomiyelitinin Nadir Bir Etkeni: Fusobacterium necrophorum

Year 2016, , 143 - 148, 30.04.2016

Ahmet Salduz Necmettin Turgut , Serkan Bayram Murat Altan Mehmet Chodza Mehmet Ekinci Turgut Akgül

https://doi.org/10.21673/anadoluklin.180740

Abstract

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.

Keywords

Fusobacterium necrophorum, osteomiyelit, sement kaplı çivi

An Uncommon Pathogen Causing Long Bone Osteomyelitis: Fusobacterium necrophorum

Abstract

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.

Keywords

Fusobacterium necrophorum, osteomyelitis, cement-coated nail

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