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Extended-spectrum β-lactamase-producing Escherichia coli rib osteomyelitis with debridement and vacuum-assisted closure
  1. Suguru Mitsui1,
  2. Shunsuke Tauchi1,
  3. Shinpei Mizuki2 and
  4. Satoshi Tobe1
  1. 1Thoracic Surgery, Akashi Medical Center, Akashi, Hyogo, Japan
  2. 2Internal Medicine, Akashi Medical Center, Akashi, Hyogo, Japan
  1. Correspondence to Dr Suguru Mitsui;{at}


Rib osteomyelitis is a rare disease, comprising 1% or less of all osteomyelitis. Treatment of rib osteomyelitis includes prolonged antibiotic therapy and surgical intervention. Indications for surgical treatment of rib osteomyelitis remain unclear, however, because of few reported cases. We report the first known case of extended-spectrum β-lactamase-producing Escherichia coli rib osteomyelitis caused by urosepsis. The 69-year-old male patient remains free of recurrence and symptoms after rib resection and vacuum-assisted closure treatment with antibiotic therapy. Rib osteomyelitis should be considered as differential diagnosis when patients report chest pain after bacteraemic infection. We recommend surgical treatment for patients with drug-resistant bacterial rib osteomyelitis.

  • bone and joint infections
  • urinary tract infections

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  • Contributors SM conceived of the presented idea and wrote the manuscript with support from ST, SM and ST. ST and ST were involved in planning and supervised the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.