Rare case of osteomyelitis relapse due to fungal activation of dermatophytosis: A report

Relapsed childhood polymicrobial osteomyelitis associated with dermatophytosis has not been reported in the literature.

Authors have reported case of a 45-year-old man who had left tibial osteomyelitis for 29 years, accompanied by skin fungal infection of the ipsilateral heel for 20 years, and underwent a second operation due to recurrence of polymicrobial infection 6 years ago. The patient had a history of injury from a rusty object, which penetrated the anterior skin of the left tibia middle segment causing subsequent bone infection, but was asymptomatic after receiving treatments in 1983. The patient was physically normal until dermatophytosis occurred on the ipsilateral heel skin in 1998. The patient complained that the dermatophytosis gradually worsened, and the tibial wound site became itchy, red, and swollen. The left tibial infection resurged in May 2012, leading to the patient receiving debridement and antibiotic treatment. H&E and Gram-stained histology was performed on biopsy specimens of sequestrum and surrounding inflammatory tissue. Tissue culture and microbiology examination confirmed polymicrobial infection with Staphylococcus aureus (S. aureus), Corynebacterium, and a fungus. Additionally, the patient also received potassium permanganate for dermatophytosis when he was admitted to the hospital.

Thus, together with longitudinal follow-up of medical history, surgical findings, histopathological and microbiology culture evidence, researchers conclude that boyhood tibia polymicrobial osteomyelitis with S. aureus and Corynebacterium occurred in this patient, and the fungal activation of dermatophytosis may have led to osteomyelitis relapse.

Reference:

Relapsed boyhood tibia polymicrobial osteomyelitis linked to dermatophytosis: a case report by Ping Kong et al. published in the BMC Surgery.

https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-022-01600-4

Keywords:

Relapsed, boyhood, tibia, polymicrobial, osteomyelitis, linked, dermatophytosis, case report, Ping Kong, Youliang Ren, Jin Yang, Wei Fu, Ziming Liu, Zhengdao Li, Wenbin He, Yunying Wang, Zhonghui Zheng, Muliang Ding, Edward M. Schwarz, Zhongliang Deng & Chao Xie BMC Surgery