Neisseria elongata osteomyelitis: Literature review and case report in a 63-year-old male presenting with progressive right-handed redness, swelling and pain

Abstract

Introduction: Neisseria elongata, a gram-negative rod, has been identified in 23 cases of pathogenesis in the literature, of which only 2 were osteomyelitis. Here we report the third known case of isolated N. elongata cultures in a digital osteomyelitis.

Presentation of case: A 63-year-old male with peripheral vascular disease and lower extremity wounds presented to his vascular surgeon with right-handed redness and pain requiring urgent surgical intervention. Irrigation, debridement, and partial thumb amputation were performed, followed by treatment with a 6-week course of antibiotics.

Discussion: N. elongata is a rare cause of osteomyelitis and unfamiliarity with the causal organism and rod-like morphology may delay diagnosis and treatment.

Conclusion: Gram-negative coverage should be considered in high-risk populations with cellulitis to prevent progression to fulminant abscesses, suppurative tenosynovitis and osteomyelitis.

Keywords: Gram-negative rod; Management; Neisseria elongata; Osteomyelitis.

Fig. 1

Right hand, pre-operative gross image and X-ray.