Rare Intercondylar Distal Femoral Brodie’s Abscess in a 21-Year-Old Man Who Refused Medical Care for Three Years after Initial Symptoms

Brodie’s abscess is a rare form of sub-acute osteomyelitis that implies the collection of pus inside bone tissue. The present paper presents an extremely rare case of Brodie’s abscess located in the distal femur in a young male patient who refused medical care for three years and presented directly...

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Published in:Medicina (Kaunas, Lithuania) Lithuania), 2021-06, Vol.57 (6), p.544
Main Authors: Hogea, Bogdan Gheorghe, Patrascu, Jenel Marian, Lazarescu, Adrian Emil, El Mehdi, Louchi, Bolovan, Andrei Daniel, Hogea, Lavinia Maria, Ilie, Adrian Cosmin, Andor, Bogdan Corneliu
Format: Article
Language:English
Subjects:
Abscesses
Antibiotics
Blood tests
Bone marrow
Brodie’s abscess
Case Report
Cement
chronic osteomyelitis
Debridement
Edema
Fistula
Fractures
infection
Infections
Magnetic resonance imaging
Pain
Pathology
Physiology
Range of motion
Surgery
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Summary:Brodie’s abscess is a rare form of sub-acute osteomyelitis that implies the collection of pus inside bone tissue. The present paper presents an extremely rare case of Brodie’s abscess located in the distal femur in a young male patient who refused medical care for three years and presented directly with spontaneous fistula and septic complications. Laboratory tests also suggested chronic septic alterations. Complex imaging investigations including X-ray (RX), computer tomography (CT) and Magnetic Resonance imaging (MRI) confirmed the diagnosis with characteristic aspects, such as the penumbra sign on the T1 weighted MRI image. Management included aggressive debridement, defect reconstruction, and long-term specific antibiotics according to culture harvested intra-operatively. Evolution was positive with inflammatory blood tests returning to physiological values within four weeks and patient full recovery within six months, without any physical deficits. The novelty aspect found in this case presentation is represented by the long-term natural evolution of this pathology, and the fact that even in these conditions, the Brodie’s abscess did not evolve into a ‘malignant’ septic condition, but remained rather benign until the spontaneous fistula prompted the patient to seek medical care.
ISSN:1648-9144
1010-660X
1648-9144
DOI:10.3390/medicina57060544