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Neth J Med. 2017 Apr;75(3):121-124.

Spontaneous fracture of the femur due to osteomyelitis caused by the Streptococcus anginosus group.

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Department of Internal Medicine, Amphia Hospital, Breda, the Netherlands.


A 57-year-old man was admitted because of pain in the right upper leg due to an osteolytic lesion of the femoral bone which was complicated by a spontaneous fracture. At first a malignancy was suspected. However, blood and bone cultures revealed the Streptococcus anginosus group. A diagnosis of acute osteomyelitis was made. In spite of extensive antibiotic and surgical treatment the patient developed severe septic shock with multiple organ failure and died. In the case of a pathological fracture, one should consider the broad differential diagnosis, including osteomyelitis, which should lead to a laboratory work-up and imaging studies. When bone biopsy for histological analysis is necessary, a microbiological culture to look for osteomyelitis should always be performed.

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