Eikenella corrodens vertebral osteomyelitis secondary to direct inoculation: a case report.

STUDY

DESIGN

A case report.

OBJECTIVE

To present a unique method of inoculation with an unusual bacterial organism, Eikenella corrodens, which led to vertebral osteomyelitis and to heighten awareness of different bacterial organisms that may cause orthopedic infections.

SUMMARY OF BACKGROUND DATA: E. corrodens has been known to cause orthopedic infections for more than 20 years. The usual mechanism is from "Fight bite" injuries to the hand or metacarpal phalangeal joint. Eikenella osteomyelitis of the vertebral body is extremely rare.

METHODS

A 65-year-old man from Indonesia developed slowly progressive vertebral collapse and worsening neck pain. History suggested a previous pharyngeal injury while eating fish. Work up for malignancy was negative, and imaging studies were suggestive of osteomyelitis. An open biopsy and culture as well as fusion were performed for treatment of the osteomyelitis.

RESULTS

After a complete work up was undertaken, cultures grew out E. corrodens as the causative organism of this patient's osteomyelitis. Computed tomography scan and history were consistent with inoculation of the paravertebral space with E. corrodens secondary to a fish bone transgressing the patient's pharynx. The patient was treated with surgery and the appropriate antibiotics and healed without any significant sequela.

CONCLUSION

Vertebral osteomyelitis due to E. corrodens is extremely rare. Direct inoculation as a cause of vertebral osteomyelitis with Eikenella has never been reported. If diagnosed properly with appropriate cultures and antibiotic sensitivities, Eikenella osteomyelitis can be treated successfully according to standard orthopedic practices including debridement, fusion, and appropriate antibiotics. Awareness of unusual bacteria as potential causative organisms of osteomyelitis is imperative for appropriate treatment.