Internalization of bacteria by osteoblasts in a patient with recurrent, long-term osteomyelitis. A case report
Abstract
O steomyelitis, an infection of bone that can be acute, subacute, or chronic with sporadic recurrence, can result in prolonged and expensive treatment1,2. Treatment strategies, which usually depend on the stage of the disease at the time of diagnosis, often include debridement of the infected area, soft-tissue coverage, and subsequent long periods of antibiotic therapy. With the increasing development of antibiotic-resistant bacteria, antibiotic therapy has become even more problematic.
Recent research has greatly advanced our understanding of the pathobiology of osteomyelitis. Studies by one of us (W.K.R.) and colleagues demonstrated that live and dead Staphylococcus aureus, the primary pathogen associated with osteomyelitis, can be internalized in vitro by osteoblasts isolated from calvariae of sixteen-day-old chick embryos3,4. Bacteria were identified both within vesicles and free in the osteoblast cytoplasm. This demonstration that bacteria can be sequestered from the host immune system within the osteoblast cytoplasm has been a breakthrough in our understanding of osteomyelitis as it provides an hypothesis to explain the recurrence of this condition.
To our knowledge, demonstration of internalization of bacteria by osteoblasts in vivo has not been reported. The purpose of the present study was to examine osteoblasts in surgical bone specimens from a patient who presented with chronic osteomyelitis that had been recurrent over a period of many years.
Before surgery, the…
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Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
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