Clostridium septicum osteomyelitis

With more ready availability of improved anaerobic culture techniques, the incidence of osteomyelitis caused by anaerobic bacteria appears greater than what was previously appreciated. The anaerobic isolates principally implicated include various Bacteroides species and gram-positive cocci. Osteomyelitis caused solely by a Clostridial species is rare and C. septicum in particular has been described only once. We present an 19-year-old Caucasian female who developed Clostridium septicum osteomyelitis of the right humerus after an elective surgical resection of a giant cell tumor of the proximal portion of the humerus. Early treatment with extensive surgical debridement and prolonged parenteral antimicrobial therapy resulted in complete recovery. A high index of suspicion is needed to make this diagnosis. The present case emphasizes the need for obtaining anaerobic as well as aerobic cultures on all suspected cases of osteomyelitis. Furthermore, prompt treatment to cover anaerobic organisms such as Clostridia species is required long before culture results can be obtained to reduce morbidity and mortality. To the best of our knowledge, this is only the second documented case of osteomyelitis caused by C. septicum as a single pathogen.