PDF(Pubmed)
Abstract：
Osteomyelitis is an inflammation of the bone tissue that results from an infection. Bacteria can reach the bone through the bloodstream. Predisposed individuals include immunocompromised patients, such as diabetics and HIV patients. Older age and trauma are common risk factors for osteomyelitis. We report a case of osteomyelitis where a male in his early seventies came to the Emergency Department with a right swollen finger without having any history of trauma or infection. With the patient\'s history, we could not find anything to explain the presenting symptoms\' cause. While performing the physical exam, we noticed the patient had a colostomy bag and went in-depth on this topic. He says he cleans his colostomy bag daily with his right hand. After evaluating the patient, surgery was performed with an incision and drainage. Diagnosis was made via MRI images and wound culture results, which showed early developing osteomyelitis and anaerobic Gram-positive cocci. These bacteria are commonly found in the gastrointestinal tract. While discussing this case with infectious disease, we could not rule out that the cause of this patient\'s infection could be because of improper hygiene protocols while changing his colostomy bag. With this case report, we aim to raise awareness of the importance of having proper hygiene when cleaning colostomy bags, as this can alter our skin barrier and organisms can enter and establish bone infections.
摘要：
骨髓炎是由感染引起的骨组织的炎症。细菌可以通过血液到达骨骼。易感个体包括免疫功能低下的患者，如糖尿病患者和HIV患者。高龄和外伤是骨髓炎的常见危险因素。我们报告了一例骨髓炎，其中一名七十多岁的男性带着右手肿胀的手指来到急诊科，没有任何外伤或感染史。根据病人的病史,我们找不到任何解释出现症状的原因。在进行身体检查时，我们注意到病人有一个结肠造口袋，并深入讨论了这个话题。他说他每天用右手清洁结肠造口袋。对病人进行评估后,手术进行了切口和引流。通过MRI图像和伤口培养结果进行诊断。显示早期发展的骨髓炎和厌氧革兰氏阳性球菌。这些细菌通常在胃肠道中发现。在与传染病讨论这个病例时，我们不能排除该患者感染的原因可能是由于更换结肠造口袋时卫生规程不当。有了这个病例报告,我们的目标是提高人们对清洁结肠造口袋时保持适当卫生重要性的认识，因为这可以改变我们的皮肤屏障，生物体可以进入并建立骨感染。
