Department of Orthopaedics, Leiden University Medical Center, Leiden, 2333ZA, the Netherlands.
Department of Biomedical Data Sciences & Medical Decision Making, Leiden University Medical Center, Albinusdreef 2, Leiden, 2333ZA, the Netherlands.
Eur J Clin Microbiol Infect Dis. 2023 Sep;42(9):1055-1061. doi: 10.1007/s10096-023-04640-7. Epub 2023 Jul 20.
Hematogenous osteomyelitis caused by Streptococcus intermedius is rare, particularly in immunocompetent adults. The aim of this paper is to provide an overview of the clinical presentation, prognosis as well as treatment of this disease, with the focus on immunocompetent adults. Six medical literature libraries were searched to identify studies reporting on Streptococcus intermedius induced hematogenous osteomyelitis in immunocompetent adults. In addition, we presented a case of a 44-year-old man from our institution that is illustrative for this disease. Four case reports describing four patients were identified by this systematic literature review. Hence, the data of five patients (including our case) were assessed. The most common presenting symptom was localised pain, followed by fever. Portal entries were found in two patients (general periodontitis and necrotic dentition). The localisations of osteomyelitis were diverse: femoral (two patients), lumbar spine (two patients), and the iliac bone (one patient). Treatment strategies varied strongly, but antibiotics (penicillins) were administered in each case, and two patients underwent surgical debridement. Follow-up ranged from 2 weeks to more than 6 months; one patient died from septic shock. Only a very limited number of immunocompetent adults with Streptococcus intermedius induced hematogenous osteomyelitis have been described. Based on the available data, we summarised the clinical presentation, prognosis as well as treatment of hematogenous osteomyelitis caused by Streptococcus intermedius in this patient population.
中间链球菌引起的血源性骨髓炎很少见，特别是在免疫功能正常的成年人中。本文旨在提供对这种疾病的临床特征、预后和治疗的概述，重点是免疫功能正常的成年人。我们检索了六个医学文献库，以确定报告免疫功能正常的成年人中间链球菌引起的血源性骨髓炎的研究。此外，我们还介绍了我院的一个病例，该病例对这种疾病具有说明性。通过系统文献回顾，确定了四例描述四例患者的病例报告。因此，评估了五名患者（包括我们的病例）的数据。最常见的首发症状是局部疼痛，其次是发热。两名患者有门户入口（一般牙周炎和坏死性牙列）。骨髓炎的定位多种多样：股骨（两名患者）、腰椎（两名患者）和髂骨（一名患者）。治疗策略差异很大，但在每种情况下都使用了抗生素（青霉素），两名患者接受了手术清创。随访时间从 2 周到 6 个月以上；一名患者死于感染性休克。仅有非常有限的免疫功能正常的成年人被描述为中间链球菌引起的血源性骨髓炎。根据现有数据，我们总结了该患者人群中由中间链球菌引起的血源性骨髓炎的临床表现、预后和治疗。
