Osteomyelitis in limb amputated by amniotic band sequence

BMJ Case Rep. 2019 Apr 14;12(4):e228588. doi: 10.1136/bcr-2018-228588.

Abstract

A preterm (30+2 week) neonate with below-knee amputation (right lower limb), constriction rings and syndactyly, subsequent to amniotic band sequence, developed pus discharge from the right tibial stump. The neonate did not have clinical features of systemic sepsis. Blood culture was sterile. The pus culture, however, grew methicillin-resistant coagulase-negative Staphylococcus and bone scan was suggestive of osteomyelitis of right proximal tibial stump. Osteomyelitis was likely caused by the contiguous spread of infection from the exposed stump. Neonate was treated with intravenous antibiotics for 4 weeks and discharged on oral feeds.

Keywords: bone and joint infections; infections; neonatal intensive care; orthopaedics.

Publication types

  • Case Reports

MeSH terms

  • Amniotic Band Syndrome / complications
  • Amniotic Band Syndrome / embryology
  • Amniotic Band Syndrome / physiopathology*
  • Amputation Stumps / blood supply
  • Amputation Stumps / microbiology
  • Amputation Stumps / pathology*
  • Amputation, Surgical*
  • Anti-Bacterial Agents / therapeutic use
  • Humans
  • Infant, Newborn
  • Lower Extremity / blood supply
  • Lower Extremity / embryology
  • Lower Extremity / microbiology
  • Lower Extremity / pathology*
  • Male
  • Methicillin-Resistant Staphylococcus aureus / pathogenicity*
  • Osteomyelitis / drug therapy
  • Osteomyelitis / embryology
  • Osteomyelitis / pathology*
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / physiopathology*
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents

Supplementary concepts

  • Amniotic Band Sequence