Femoral osteomyelitis caused by oral anaerobic bacteria with mixed bacteremia of Campylobacter rectus and Parvimonas micra in a chronic periodontitis patient: a case report

• DOI: 10.1186/s12879-022-07573-2
• Publication Date: 2022-07-14T07:02:58Z
• Authors: Naoya Itoh; Nana Akazawa; Yuichi Ishibana; Shunsuke Hamada; Sumitaka Hagiwara; Hiromi Murakami
• Keywords: Male; 0301 basic medicine; Fusobacterium nucleatum; Peptostreptococcus; Firmicutes; Case Report; Bacteremia; Osteomyelitis; Infectious and parasitic diseases; RC109-216; Abscess; 3. Good health; Wolinella recta; Bacteria, Anaerobic; 03 medical and health sciences; Campylobacter rectus; Chronic Periodontitis; Chronic periodontitis; Parbimonas micra; Humans; Femur; Aged

AbstractBackgroundCampylobacterrectus is a gram-negative rod, andParvimonas micrais a gram-positive coccus, both of which are oral anaerobes that cause chronic periodontitis. Chronic periodontitis can cause bacteremia and systemic diseases, including osteomyelitis. Hematogenous osteomyelitis caused by anaerobic bacteria is uncommon, and to date, there have been no reports of mixed bacteremia withC. rectusandP. micra. Here, we report the first case of osteomyelitis of the femur caused by anaerobic bacteria with mixed bacteremia ofC. rectusandP. micracaused by chronic periodontitis.Case presentationA 75-year-old man with chronic periodontitis, hyperuricemia, and benign prostatic hyperplasia was admitted to the hospital with a fracture of the left femur. The patient had left thigh pain for 4 weeks prior to admission. Left femoral intramedullary nail fixation was performed, and a large amount of abscess and necrotic tissue was found intraoperatively. The cultures of abscess specimens were identified asP. micra,Fusobacterium nucleatum, andC. rectus.C. rectusandP. micrawere also isolated from blood cultures.C. rectuswas identified by matrix-assisted laser desorption/ionization time-of-flight mass spectrometry and 16 S ribosomal RNA sequencing. Sulbactam-ampicillin was administered for approximately 1 month, after which it was replaced by oral clavulanic acid-amoxicillin for long-term suppressive treatment.ConclusionsOnly five cases of bloodstream infection withC. rectushave been reported, and this is the first report of mixed bacteremia withP. micra. Clinicians should consider that chronic periodontitis caused by rare oral anaerobic bacteria can cause systemic infections, such as osteomyelitis.