Direct inoculation osteomyelitis due to Eikenella corrodens following oral radiation therapy.

Abstract

A 54-year-old male presented to his local otolaryngology clinic following surgical removal of a squamous cell carcinoma of his left tonsil and subsequent chemotherapy and radiation. Large amount of swelling was noticed underneath his chin. Purulent material was drained and cultured revealing Eikenella corrodens. The patient was placed on a broad-spectrum intravenous antibiotic therapy and his condition began to improve dramatically. OBJECTIVES: Define the term osteomyelitis and describe the pathogenesis of this condition; identify the common bacterial causes of osteomyelitis; explain the etiologic nature of the organism, Eikenella corrodens, and its uniqueness to this case. ABBREVIATIONS:AIDS = acquired immunodeficiency syndrome; CBC = complete blood cell count; CNA = colistin nalidixic acid; CRP = C-reactive protein; CT = computed tomography; ESR = erythrocyte sedimentation rate; HACEK = group of gram-negative bacilli; IV = intravenous; MRI = magnetic resonance imaging; PEG = percutaneous endoscopic gastrostomy; PICC = peripherally inserted central catheter; RBC = red blood cell; WBC = white blood cell.