Abstract
INTRODUCTION: Hematogenous osteomyelitis of long bones in immunocompetent adults is extremely rare and uncommonly presents as a pathological fracture. CASE REPORT: A 53-year-old Caucasian male presented with an atraumatic mid-shaft femur fracture secondary to hematogenous osteomyelitis. The organism was found to be Streptococcus anginosus. The patient required multiple surgical debridements and was treated with an antibiotic-impregnated cement rod and external fixator along with IV Rocephin. Furthermore, the patient was on chronic Carbamazepine therapy for the refractory bipolar disorder. We discuss the effect cytochrome p450 inducing medications have on bone health and how this may have contributed to this rare presentation of pathologic fracture. CONCLUSION: We report a rare case of femoral osteomyelitis presenting as a pathologic fracture. Treatment involves multiple surgeries and an extended recovery.