Infect Chemother.  2016 Sep;48(3):234-238. 10.3947/ic.2016.48.3.234.

Olecranon Osteomyelitis due to Actinomyces meyeri: Report of a Culture-Proven Case

• Kim JY
• Kang EK
• Moon SM
• Seo YH
• Jeong J
• Cho H
• Yang D
• Park YS

• KMID: 2466439
• DOI: http://doi.org/10.3947/ic.2016.48.3.234

Abstract

Actinomyces meyeri is a Gram positive, strict anaerobic bacterium, which was first described by Meyer in 1911. Primary actinomycotic osteomyelitis is rare and primarily affects the cervicofacial region, including mandible. We present an unusual case of osteomyelitis of a long bone combined with myoabscess due to A. meyeri. A 70-year-old man was admitted for pain and pus discharge of the right elbow. Twenty-five days before admission, he had hit his elbow against a table. MRI of the elbow showed a partial tear of the distal triceps tendon and myositis. He underwent open debridement and partial bone resection for the osteomyelitis of the olecranon. Biopsy showed no sulfur granules, but acute and chronic osteomyelitis. The excised tissue grew A. meyeri and Peptoniphilus asaccharolyticus. Intravenous ceftriaxone was administered and switched to oral amoxicillin. Infection of the extremities of actinomycosis often poses diagnostic difficulties, but it should not be neglected even when the characteristic pathologic findings are not present.

Keyword

Actinomyces; Osteomyelitis; Olecranon

MeSH Terms

Actinomyces*
Actinomycosis
Aged
Amoxicillin
Biopsy
Ceftriaxone
Debridement
Elbow
Extremities
Humans
Magnetic Resonance Imaging
Mandible
Myositis
Olecranon Process*
Osteomyelitis*
Sulfur
Suppuration
Tears
Tendons
Amoxicillin
Ceftriaxone
Sulfur

Figure

• 

  Figure 1 The wound on the right elbow with three-centimeter of laceration and signs of inflammation.

• 

  Figure 2 (A) MRI T2 coronal slide of the epicondyle showing partial tear of the distal triceps tendon, from olecranon insertional portion to 5 cm above. (B) MRI T2 axial slide (enhanced). Complicated hematoma with myositis and cellulites is also noted (arrow).

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  Figure 3 Abscess is noted, mostly composed of neutrophils. Abscess surrounds mature bone fragments. (Hematoxylin and eosin stain, x200)

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