Corynebacterium minutissimum as a Rare Cause of Tibial Osteomyelitis: A Case Report and Literature Review.

Osteomyelitis is commonly caused by pathogens like Staphylococcus aureus, but rare organisms such as Corynebacterium minutissimum, typically associated with superficial skin infections, can also be implicated. Recognizing these atypical pathogens presents diagnostic and therapeutic challenges, especially in the presence of orthopedic hardware. We conducted a literature review yielding 25 studies and encompassing 797 patient cases, which highlights the emerging role of Corynebacterium species in osteomyelitis, particularly following trauma or surgical interventions. A 72-year-old man with a history of chronic right tibia and fibula fractures from a motor vehicle accident presented with progressively worsening leg pain over six months. Imaging revealed hardware failure and new fractures. Surgical intervention involved hardware removal, osteotomy, and placement of an external fixator. Intraoperative cultures eventually grew C. minutissimum which was resistant to ceftriaxone but sensitive to doxycycline. His antibiotic regimen was switched from intravenous cefazolin to oral doxycycline, leading to gradual pain improvement and stable clinical status. This case adds to the growing body of literature on C. minutissimum as a rare but significant cause of osteomyelitis, particularly in patients with orthopedic hardware. Our literature review emphasizes the need for clinicians to be vigilant for Corynebacterium species in cases of osteomyelitis unresponsive to standard treatments. Early recognition and targeted antimicrobial therapy guided by susceptibility testing are crucial for successful outcomes in managing atypical bone infections.