Going Bone Deep: Osseous Rosai–Dorfman Disease in an Adult with Recurrent, Culture-Negative Osteomyelitis

A patient presented for medical care on three separate occasions over the course of two years with recurrent right knee pain attributed to chronic osteomyelitis. Careful assessment revealed that his symptoms were caused by osseous Rosai–Dorfman disease. This case presents an alternative diagnostic possibility for culture-negative chronic osteomyelitis.

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Culture-negative chronic hematogenous osteomyelitis in a two months old girl: a case report

BMC Musculoskeletal Disorders ◽

10.1186/s12891-021-04547-4 ◽

2021 ◽

Vol 22 (1) ◽

Author(s):

Cheng-he Qin ◽

Rui Tao ◽

Ji-wei Luo ◽

Liang Hong ◽

Lei Xu ◽

...

Keyword(s):

Chronic Osteomyelitis ◽

Bone Destruction ◽

Good Recovery ◽

Resonance Imaging ◽

Case Presentation ◽

Negative Culture ◽

Hematogenous Osteomyelitis ◽

Acute Hematogenous Osteomyelitis ◽

Culture Negative

Abstract Background Previous articles have focused on the diagnosis and treatment of acute hematogenous osteomyelitis. Here, we present a case of chronic hematogenous osteomyelitis in a 2-month-old girl. The diagnostic procedure was unusual and difficult due to negative culture results. Case presentation A girl aged 2 months and 23 days had fever and swelling in her right lower leg for 7 days. On the basis of her medical history, physical, and histological examination results; and radiologic and magnetic resonance imaging findings, a diagnosis of chronic osteomyelitis was made. The patient underwent surgical treatment and was discharged successfully. The patient showed good recovery and no sequelae at the 12-month follow-up. Conclusion Hematogenous osteomyelitis in babyhood is different from that at any other age. Hematogenous osteomyelitis-related bone destruction in babyhood is more serious and occurs faster. The transition from acute hematogenous osteomyelitis to chronic hematogenous osteomyelitis takes only 7 days. To the best of our knowledge, this chronic hematogenous osteomyelitis patient is the youngest ever reported.

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Prevalence of knee pain and knee OA in southern Sweden and the proportion that seeks medical care

Rheumatology ◽

10.1093/rheumatology/keu409 ◽

2014 ◽

Vol 54 (5) ◽

pp. 827-835 ◽

Cited By ~ 59

Author(s):

A. Turkiewicz ◽

M. Gerhardsson de Verdier ◽

G. Engstrom ◽

P. M. Nilsson ◽

C. Mellstrom ◽

...

Keyword(s):

Medical Care ◽

Knee Pain ◽

Southern Sweden ◽

Knee Oa

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Subacute knee pain and swelling in a healthy male: a case of Brodie’s abscess

BMJ Case Reports ◽

10.1136/bcr-2018-227926 ◽

2019 ◽

Vol 12 (3) ◽

pp. e227926

Author(s):

Mitesh K Patel ◽

Steven Barrientos ◽

Sunny Gupta ◽

Bradford Tucker

Keyword(s):

Antibiotic Therapy ◽

Knee Pain ◽

Inflammatory Process ◽

Chronic Osteomyelitis ◽

Early Recognition ◽

Healthy Male ◽

Timely Manner ◽

Successful Management ◽

Brodie’S Abscess ◽

Avascular Necrosis Of Bone

Osteomyelitis is an inflammatory process of the bone caused by an infection. The key to successful management is early recognition and treatment, as complications can arise if interventions are not done in a timely manner. Subacute or chronic osteomyelitis is associated with avascular necrosis of bone requiring surgical debridement and antibiotic therapy. Here, we describe a case illustrating an uncharacteristic presentation of knee pain ending with multiple surgical debridements in a healthy male.

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Intensity of 18F-FDG PET Uptake in Culture-Negative and Culture-Positive Cases of Chronic Osteomyelitis

Contrast Media & Molecular Imaging ◽

10.1155/2017/9754293 ◽

2017 ◽

Vol 2017 ◽

pp. 1-9 ◽

Cited By ~ 4

Author(s):

Petteri Lankinen ◽

Marko Seppänen ◽

Kimmo Mattila ◽

Markku Kallajoki ◽

Juhani Knuuti ◽

...

Keyword(s):

Fdg Pet ◽

Chronic Osteomyelitis ◽

False Negative ◽

Low Grade ◽

Active Infection ◽

Bacterial Cultures ◽

Appropriate Treatment ◽

Histopathologic Diagnosis ◽

Culture Positive ◽

Culture Negative

Microbiologic cultures are not infrequently negative in patients with a histopathologic diagnosis of chronic osteomyelitis. Culture-negative cases may represent low-grade infections with a lower metabolic activity than culture-positive cases. 18F-FDG PET could potentially detect such a difference. We determined whether the level of 18F-FDG PET uptake differs in patients with culture-negative and culture-positive osteomyelitis. We reviewed the clinical charts of 40 consecutive patients, who had diagnostic 18F-FDG PET for a suspected bone infection. Twenty-six patients were eligible with a confirmed diagnosis based on microbiologic cultures and/or histopathologic examination. Sixteen of 26 patients had chronic osteomyelitis. Eight of them had positive cultures, seven had negative cultures, and one patient had no cultures of the biopsy specimen. The patients with histologically and/or microbiologically proven osteomyelitis were correctly interpreted as true positive in the routine clinical reading of 18F-FDG PET images. There was no relationship between the level of 18F-FDG PET uptake and the presence of positive or negative bacterial cultures. The result favors the concept that that culture-negative cases of osteomyelitis are false-negative infections due to nonculturable microbes. 18F-FDG PET may help to confirm the presence of metabolically active infection in these patients and guide their appropriate treatment.

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New premises and new tools for medical care and education

Journal of Dental Education ◽

10.1002/j.0022-0337.1996.60.1.tb03013.x ◽

1996 ◽

Vol 60 (1) ◽

pp. 64-67

Author(s):

LL Weed

Keyword(s):

Medical Care

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The Collaborative Medical and Behavioral Management of Chronic Cough

Perspectives on Voice and Voice Disorders ◽

10.1044/vvd19.2.49 ◽

2009 ◽

Vol 19 (2) ◽

pp. 49-57

Author(s):

Brian E. Petty ◽

Seth H. Dailey

Keyword(s):

Medical Care ◽

Chronic Cough ◽

Therapeutic Management ◽

Ambulatory Setting ◽

Behavioral Management ◽

Speech Language Pathologists ◽

Speech Language Pathologist ◽

The Many ◽

Frequent Reason

Abstract Chronic cough is the most frequent reason cited by patients for seeking medical care in an ambulatory setting and may account for 10% to 38% of a pulmonologist's practice. Because chronic cough can be caused by or correlated with a wide array of disorders and behaviors, the diagnosis of etiologic factors and determination of appropriate therapeutic management in these cases can prove to be daunting for the physician and speech-language pathologist alike. This article will describe the phenomenon of chronic cough, discuss the many etiologic factors to consider, and review some of the more common ways in which speech-language pathologists and physicians collaborate to treat this challenging condition.

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