Case reportLeuconostoc Osteomyelitis
Introduction
Leuconostoc spp. is widely used in the food industry to produce fermented dairy products and wine. Until 1984, Leuconostoc spp. was considered to be devoid of pathogenic potential. Since then, several cases of human infection have been reported [1], [2], [3], [4]. We report the first case of tibial osteomyelitis due to Leuconostoc spp.
Section snippets
Case-report
A 52-year-old man was referred to our department in December 2000, for pain in the right tibia. He had a 20-year history of chronic bilateral idiopathic lymphedema of the lower limbs. In February 2000, he started experiencing severe pain in the right shin, where a 2-cm by 1-cm inflammatory swelling had developed. The overlying skin was normal. His body temperature was normal and his general health was good. The rest of the physical evaluation was normal. He reported a recent history of
Discussion
Leuconostoc is a small gram-positive coccobacillus or coccus that belongs to the Streptococcacae family. This catalase-negative organism grows under both anaerobic and aerobic conditions. It is ubiquitously distributed in the soil and is not part of the normal saprophytic flora found in humans. It is often mistaken for a Streptococcus spp. with which it shares many morphological and biochemical characteristics [5]. All Leuconostoc spp. are resistant to vancomycin [6] via a chromosomal mechanism
Conclusion
Leuconostoc infection is uncommon, but deserves to be borne in mind. Although immunodepression is present in most patients, Leuconostoc infection can develop in the absence of risk factors. The epidemiological characteristics of Leuconostoc infections remain to be determined. The organism can be difficult to identify by bacteriological testing. Leuconostoc infection should be considered when a vancomycin-resistant gram-positive coccus is found. Most strains are susceptible to betalactams.
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