Mayhew Jonathan A, Christenson John C, Alali Muayad
Department of Pediatrics, Ryan White Center for Pediatric Infectious Diseases and Global Health, Indiana University, Indianapolis, IN, USA.
Deparment of Pediatric & Adolescent Medicine, Western Michigan University Homer Stryker M. D. School of Medicine, Kalamazoo, MI, USA.
Transl Pediatr. 2024 Feb 29;13(2):350-358. doi: 10.21037/tp-23-492. Epub 2024 Feb 23.
() is an unusual cause of osteomyelitis. Infection may develop following open trauma, intravenous drug abuse, or in the presence of hardware, but osteoarticular infections outside of this context are atypical in the absence of immunodeficiency. Rarely, a chronic indolent infection may develop after open trauma with disease recurrence years after the initial injury.
We present the case of a 16-year-old male with extensive left lower extremity osteomyelitis secondary to eight years after an open fracture to this leg was complicated by an infection with the same organism. Suboptimal therapy of his initial infection may have contributed to persistent, latent disease before recurrence years later. Evaluation for immunodeficiency was negative and he responded well to ciprofloxacin antibiotic therapy.
infection may complicate open fractures, and, if not adequately treated, a chronic, indolent infection may result, with disease recurrence years later. We stress the importance of adequate therapy for infectious complications following open fractures and discuss virulence factors of that may allow this organism to evade the immune system and survive subclinically within a host. The optimal therapy of osteomyelitis is not established and further studies are needed to best guide the therapeutic approach.
（病原体名称）是骨髓炎的一种不常见病因。感染可能在开放性创伤、静脉药物滥用后发生，或在有内固定装置的情况下出现，但在无免疫缺陷的情况下，这种情况下的骨关节炎感染并不典型。很少见的是，开放性创伤后可能会发展为慢性隐匿性感染，在初次受伤数年之后疾病复发。
我们报告一例16岁男性，其左下肢广泛骨髓炎继发于该腿部开放性骨折8年后，此次骨折因感染同一病原体而复杂化。他最初感染的治疗不充分可能导致了疾病持续存在、潜伏，直至数年之后复发。免疫缺陷评估为阴性，他对环丙沙星抗生素治疗反应良好。
（病原体名称）感染可能使开放性骨折复杂化，如果治疗不充分，可能导致慢性隐匿性感染，并在数年之后疾病复发。我们强调开放性骨折后对感染并发症进行充分治疗的重要性，并讨论（病原体名称）的毒力因子，这些因子可能使该病原体逃避免疫系统并在宿主体内亚临床存活。（病原体名称）骨髓炎的最佳治疗方法尚未确定，需要进一步研究以更好地指导治疗方法。
