Wu Jiangyan,Hu Xiongke,Zeng Lingrong,et al.Subacute epiphyseal osteomyelitis caused by Fusobacterium nucleatum in distal femur:one case report with a literature review[J].Journal of Clinical Pediatric Surgery,,22():1189-1193.[doi:10.3760/cma.j.cn101785-202310052-017]
Subacute epiphyseal osteomyelitis caused by Fusobacterium nucleatum in distal femur:one case report with a literature review
- Keywords:
- Femur; Osteomyelitis; Fusobacterium nucleatum; Infections; Treatment Outcome; Child
- Abstract:
- Objective To explore the clinical characteristics,diagnoses and treatments of subacute osteomyelitis of epiphyseal plate caused by Fusobacterium nucleatum infection in children.Methods Clinical data were retrospectively reviewed for a child with subacute osteomyelitis of distal femoral epiphysis caused by F.nucleatum infection admitted on July 9,2023.The relevant literature items of F.nucleatum-induced osteomyelitis in children were retrieved from the databases of PubMed,Wanfang Medical Network and CNKI from 1970 to 2023.Clinical manifestations,diagnoses,treatments and outcomes were analyzed.Results A 50-month-old boy with osteomyelitis of right distal femoral metaphysis was hospitalized.The pathogenic anaerobic Gram-negative bacillus was confirmed as G-proteobacterium by intraoperative tissue microbiome analysis using next generation sequencing (NGS).After 11-day treatment of clindamycin,local lesion debridement,bone augmentation with clindamycin-impregnated synthetic bone graft and cartilage repair of femoral condyle joint were performed.During 10-week follow-ups,the symptoms of right femur disappeared and knee joint function normalized.A search of domestic and foreign databases revealed that only 10 cases have been reported and there was no domestic report.Among 10 reported children with G-proteobacterium osteomyelitis,diagnosis was confirmed by tissue culture (n=9) and polymerase chain reaction (PCR,n=1).The interventions included lesion drainage (n=7),medication alone (n=3) and dosing of sensitive antibiotics (n=11).Follow-up showed disappearance of symptoms and near-normal motor function.Conclusions G-proteobacterium may cause osteomyelitis in children.There are common signs of fever and local pain.Imaging studies reveal bone destruction and abnormal signals in bone marrow and surrounding tissues.Anaerobic culture and NGS are important diagnostic tools for confirming G-proteobacterium infection-related osteomyelitis.Local debridement and dosing of sensitive antibiotics are efficacious.
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Memo
收稿日期:2023-10-28。
基金项目:儿童骨科学湖南省重点实验室专项经费资助 (2023TP1019)
通讯作者:胡雄科,Email:huxiongke@163.com