Case Report

Osteomyelitis Concurrently Caused by Staphylococcus aureus and Mycobacterium tuberculosis

Authors: Ing-Kit Lee, MD, Jien-Wei Liu, MD

Abstract

We report the case of a 59-year-old woman who presented with fever and a cutaneous ulcer on her left ankle. In addition to Staphylococcus aureus growth from a blood culture, S aureusand Mycobacterium tuberculosis were both isolated from tissue specimens. This case highlights that osteomyelitis may be concurrently caused by S aureus and M tuberculosis. In a patient whose osteomyelitis due to S aureus responds poorly to clinical therapy, clinicians should suspect coexisting tuberculosis, especially in areas where tuberculosis is endemic.


Key Points


* Osteomyelitis may be concurrently caused by Staphylococcus aureus and Mycobacterium tuberculosis.


* In patients whose osteomyelitis due to S aureus responds poorly to clinical therapy, clinicians should suspect coexisting tuberculosis, especially in areas where tuberculosis is endemic.


* Additional anti-TB therapy may be initiated until TB is proven to be negative.

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References

1. Mandal S, Berendt AR, Peacock SJ. Staphylococcus aureus bone and joint infection. J Infect 2002;44:143–151.
 
2. Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res 2004;120:316–353.
 
3. Watts HG, Lifeso RM. Tuberculosis of bones and joints. J Bone Joint Surg Am 1996;78:288–298.
 
4. Yilmaz O, Cabalar M, Ozbilgin S. The in vivo and in vitro comparative nephrotoxicity of cefazolin and gentamicin. Vet Hum Toxicol 1999;41:222–225.
 
5. Kurz RW, Wallner M, Graninger W, et al. Hypoprothrombinaemia and bleeding associated with cefazolin. J Antimicrob Chemother 1986;18:772–773.
 
6. Boachie-Adjei O, Squillante RB. Tuberculosis of the spine. Orthop Clin North Am 1996;27:95–103.
 
7. Tsai MS, Liu JW, Chen WS, et al. Tuberculous wrist in the era of effective chemotherapy: an eleven-year experience. Int J Tuberc Lung Dis 2003;7:690–694.
 
8. Haas DW. Mycobacterium tuberculosis. In: Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett’s principles and practice of infectious diseases, 5th ed. New York: Churchill Livingstone, 2000, pp 2576–2607.
 
9. Turk JL. Granulomatous diseases. In: McGee JO, Isaacson PG, Wright NA, eds. Oxford textbook of pathology. Oxford, Oxford University Press, 1996, pp 394–406.
 
10. Corbett EL, Watt CJ, Walker N, et al. The growing burden of tuberculosis: global trends and interactions with the HIV epidemic. Arch Intern Med 2003;163:1009–1021.
 
11. Carlos FP, Henry MB. Psoas muscle abscess caused by Mycobacterium tuberculosis and Staphylococcus aureus: case report and review. Am J Med Sci 2001;321:415–417.
 
12. Dooley KE, Golub J, Goes FS, et al. Empiric treatment of community-acquired pneumonia with fluoroquinolones, and delays in the treatment of tuberculosis. Clin Infect Dis 2002;34:1607–1612.