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

Abstract

Background Campylobacter rectus is a gram-negative rod, and Parvimonas micra is 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 with C. rectus and P. micra. Here, we report the first case of osteomyelitis of the femur caused by anaerobic bacteria with mixed bacteremia of C. rectus and P. micra caused by chronic periodontitis. Case presentation A 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 as P. micra, Fusobacterium nucleatum, and C. rectus. C. rectus and P. micra were also isolated from blood cultures. C. rectus was 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. Conclusions Only five cases of bloodstream infection with C. rectus have been reported, and this is the first report of mixed bacteremia with P. micra. Clinicians should consider that chronic periodontitis caused by rare oral anaerobic bacteria can cause systemic infections, such as osteomyelitis.

Parvimonas micra Bacteremia in the Setting of a Hepatic Abscess: A Case Report

“…Intra-abdominal sources have also been identified as a cause of this bacteremia [ 6 ]. Many prior case reports regarding P. micra bacteremia were in the setting of immunocompromised patients or in patients with numerous comorbidities [ 1 , 2 , 5 ]. Similarly, the patient in this report had several comorbidities that made him vulnerable to this opportunistic pathogen, including his advanced age and extensive history of cardiac disease.…”

“…Reports of bacteremia in the setting of this microbe are uncommon. Few reports, however, have been published establishing an association between P. micra bacteremia and colonic carcinoma, pneumonia, empyema, and osteomyelitis [1][2][3][4][5]. This case report details the clinical course and management of a patient who had P. micra bacteremia in the setting of a hepatic abscess.…”

Periodontitis of maxillary teeth screened by community periodontal index is associated with chronic rhinosinusitis defined by EPOS 2020 guideline

“…Patients with chronic periodontitis have a high tendency to develop osteomyelitis 20 , 21 . The proposed etiology is the biofilm produced by oral anaerobes, which can even influence inflammation in distant bones, such as the femur, through the blood stream 22 . Moreover, periodontitis can induce pathological changes in tissues adjacent to the oral cavity, such as the upper jaws, with great ease, leading to chronic inflammation of the paranasal sinuses.…”

Assessment of independent variables of periodontal disease among selected South Indian population

“…found that those aged 19–35 had the most gingivitis, while the elderly had the most periodontitis. [ 22 23 24 31 32 33 34 35 36 ] Periodontitis was more common among patients aged 18–30 years according to a study on the incidence of periodontal diseases among 18–30-year-old individuals. [ 11 ] Our findings corroborate those of the prior research.…”