Osteomyelitis with Proteus mirabilis occurred in two neonates following puncture for purposes of obtaining blood specimens. Osteomyelitis of the hip and septicemia developed following femoral vein puncture in one, and osteomyelitis of the distal tibia and septicemia in the other following punctures of the lateral heel area for capillary blood chemistry determinations. Treatment in both cases was successful using ampicillin.
These cases are reminders of the possible iatrogenic complications from obtaining blood specimens and serve to illustrate the need for meticulous care in carrying out such procedure. Proteus organisms are unusual causal agents in osteomyelitis and demonstrate variable antibiotic susceptibility patterns, which in the case of P mirabilis are somewhat species specific with ampicillin being most often the antibiotic of choice.
Nelson DL, Hable KA, Matsen JM. Proteus mirabilis Osteomyelitis in Two Neonates Following Needle Puncture: Successful Treatment With Ampicillin. Am J Dis Child. 1973;125(1):109–110. doi:10.1001/archpedi.1973.04160010073017
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