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Kong P, Ren Y, Yang J, Fu W, Liu Z, Li Z, He W, Wang Y, Zheng Z, Ding M, Schwarz EM, Deng Z, Xie C. Relapsed boyhood tibia polymicrobial osteomyelitis linked to dermatophytosis: a case report. BMC Surg 2022; 22:156. [PMID: 35509041 PMCID: PMC9066813 DOI: 10.1186/s12893-022-01600-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Accepted: 04/14/2022] [Indexed: 11/16/2022] Open
Abstract
Background Relapsed childhood polymicrobial osteomyelitis associated with dermatophytosis has not been reported in the literature.
Case presentation Here we report on a case of a 45-year-old man who had left tibial osteomyelitis for 29 years, accompanied by skin fungal infection of the ipsilateral heel for 20 years, and underwent a second operation due to recurrence of polymicrobial infection 6 years ago. The patient had a history of injury from a rusty object, which penetrated the anterior skin of the left tibia middle segment causing subsequent bone infection, but was asymptomatic after receiving treatments in 1983. The patient was physically normal until dermatophytosis occurred on the ipsilateral heel skin in 1998. The patient complained that the dermatophytosis was gradually getting worse, and the tibial wound site became itchy, red, and swollen. The left tibial infection resurged in May 2012, leading to the patient receiving debridement and antibiotic treatment. H&E and Gram-stained histology was performed on biopsy specimens of sequestrum and surrounding inflammatory tissue. Tissue culture and microbiology examination confirmed polymicrobial infection with Staphylococcus aureus (S. aureus) and Corynebacterium and a fungus. Additionally, the patient also received potassium permanganate for dermatophytosis when he was admitted into the hospital.
Conclusions Together with longitudinal follow-up of medical history, surgical findings, histopathological and microbiology culture evidence, we conclude that boyhood tibia polymicrobial osteomyelitis with S. aureus and Corynebacterium occurred in this patient, and the fungal activation of dermatophytosis may have led to osteomyelitis relapse.
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Affiliation(s)
- Ping Kong
- Department of Orthopaedics, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.,Joint Orthopaedic Research Center of Zunyi Medical University and University of Rochester Medical Center, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China
| | - Youliang Ren
- Department of Orthopaedics, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400065, China
| | - Jin Yang
- Department of Orthopaedics, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.,Joint Orthopaedic Research Center of Zunyi Medical University and University of Rochester Medical Center, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China.,Department of Orthopaedics, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400065, China
| | - Wei Fu
- Department of Orthopaedics, Guizhou Provincial People's Hospital, Guiyang, 550000, China
| | - Ziming Liu
- Institute of Sports Medicine Beijing Key Laboratory of Sports Injuries Peking University Third Hospital, Beijing, 100191, China
| | - Zhengdao Li
- Department of Orthopaedics, First People's Hospital of Xuzhou, Affiliated Hospital of China University of Mining and Technology, Xuzhou, 221005, China
| | - Wenbin He
- Department of Trauma, Shanghai East Hospital, Tongji University School of Medicine, Shanghai, 200065, China
| | - Yunying Wang
- Department of Laboratory Medicine, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400065, China
| | - Zhonghui Zheng
- Department of Orthopaedics, Second Affiliated Hospital of Central South University, Changsha, 410008, China
| | - Muliang Ding
- Department of Orthopaedics, Second Affiliated Hospital of Central South University, Changsha, 410008, China
| | - Edward M Schwarz
- Department of Orthopaedics, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, 14642, USA
| | - Zhongliang Deng
- Department of Orthopaedics, Second Affiliated Hospital of Chongqing Medical University, Chongqing, 400065, China
| | - Chao Xie
- Joint Orthopaedic Research Center of Zunyi Medical University and University of Rochester Medical Center, Affiliated Hospital of Zunyi Medical University, Zunyi, 563000, China. .,Department of Orthopaedics, Center for Musculoskeletal Research, University of Rochester Medical Center, Rochester, NY, 14642, USA.
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