Multifocal bacterial osteomyelitis in a renal allograft recipient following urosepsis

Valson, Anna T; David, VG; Balaji, V.; John, George T.

doi:10.4103/0971-4065.132022

Cited by 3 publications

(2 citation statements)

References 15 publications

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“…Osteomyelitis secondary to UTI in adults usually involves the lumbar vertebrae, although there are a few rare cases of other involved bones (cervical spine, sternum, and ribs, among others)[ 2 , 5 , 9 ]. Only one case have been reported in a patient who developed both femur and tibia osteomyelitis due to UTI, and this patient was a renal allograft recipient[ 3 ]. There have been no reports of bilateral femur, knee and tibia osteomyelitis caused by hematogenous infection in an immunocompetent patient.…”

Section: Discussionmentioning

confidence: 99%

“…Most cases involve lumbar vertebral bodies; there are only a few reports involving the non-vertebral bones in the literature. Only one case reported of multifocal osteomyelitis, including both femur and tibia in a renal allograft patient after urosepsis[ 3 ]. We present the first case of both femur and tibia osteomyelitis after UTI caused by Escherichia coli ( E. coli ) in a previously healthy patient.…”

Section: Introductionmentioning

confidence: 99%

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Disseminated osteomyelitis after urinary tract infection in immunocompetent adult: A case report

Kim¹,

Lee²

2020

WJCC

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BACKGROUND Urinary tract infection (UTI) is one of the most common bacterial infections. Acute pyelonephritis or upper urinary tract infection is often accompanied by bacteremia; however, bacteremia resolves in most cases without complication. Rarely, complications due to bacteremia occur. One of these is osteomyelitis. It mainly affects the lumbar vertebral bodies, and rarely affects other site. CASE SUMMARY An 80-year-old woman presented to the hospital with a two-month history of pain in both legs. Two months ago, she was admitted to the hospital for fever, flank pain, and urinary frequency and was diagnosed with bacteremic UTI. During hospitalization, she complained of pain in both legs; however, the pain resolved shortly after, and no abnormalities were observed on physical examination. Therefore, she was placed on 2-wk antibiotic therapy for UTI without further evaluation for leg pain. However, pain recurred after discharge and persisted; therefore, an imaging test was performed. Bone scan and magnetic resonance imaging suggested osseous infection in both femurs, tibiae and patellae. Surgical treatment was performed, and tissue- and bone cultures revealed Escherichia coli , a previously observed pathogen, which demonstrated same antibiotic sensitivities, as noted in previous UTI. She was diagnosed with disseminated osteomyelitis, as a complication of UTI, and was placed on an 8-wk antibiotic therapy. CONCLUSION Indication for osteomyelitis should be high regardless of bone pain at sites other than lumbar spine after or during UTI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Disseminated osteomyelitis after urinary tract infection in immunocompetent adult: A case report

Kim¹,

Lee²

2020

WJCC

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Multi‐focal tuberculous osteomyelitis in a kidney transplant patient

et al. 2018

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Acute bacterial sternoclavicular osteomyelitis in a long-term renal transplant recipient

Dounousi

Duni

Xiromeriti

et al. 2016

WJT

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Kidney transplantation is the treatment of choice for a significant number of patients with end-stage renal disease. Although immunosuppression therapy improves graft and patient's survival, it is a major risk factor for infection following kidney transplantation altering clinical manifestations of the infectious diseases and complicating both the diagnosis and management of renal transplant recipients (RTRs). Existing literature is very limited regarding osteomyelitis in RTRs. Sternoclavicular osteomyelitis is rare and has been mainly reported after contiguous spread of infection or direct traumatic seeding of the bacteria. We present an interesting case of acute, bacterial sternoclavicular osteomyelitis in a long-term RTR. Blood cultures were positive for Streptococcus mitis, while the portal entry site was not identified. Magnetic resonance imaging of the sternoclavicluar region and a three-phase bone scan were positive for sternoclavicular osteomyelitis. Eventually, the patient was successfully treated with Daptomycin as monotherapy. In the presence of immunosuppression, the transplant physician should always remain alert for opportunistic pathogens or unusual location of osteomyelitis.

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Multifocal bacterial osteomyelitis in a renal allograft recipient following urosepsis

Abstract: Non-tubercular bacterial osteomyelitis is a rare infection. We report on a renal allograft recipient with osteomyelitis complicating urosepsis, manifesting as a multifocal infection poorly responsive to appropriate antibiotics and surgical intervention and culminating in graft loss.

Cited by 3 publications

References 15 publications

Disseminated osteomyelitis after urinary tract infection in immunocompetent adult: A case report

Disseminated osteomyelitis after urinary tract infection in immunocompetent adult: A case report

Multi‐focal tuberculous osteomyelitis in a kidney transplant patient

Acute bacterial sternoclavicular osteomyelitis in a long-term renal transplant recipient

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