Peer-reviewed veterinary case report
Osteomyelitis and osteonecrosis after intraosseous perfusion with gentamicin.
- Journal:
- Veterinary surgery : VS
- Year:
- 2010
- Authors:
- Parker, Russell A et al.
- Affiliation:
- Department of Veterinary Clinical Studies · United Kingdom
- Species:
- horse
Plain-English summary
A ten-year-old Warmblood gelding was treated with gentamicin, an antibiotic, delivered directly into the bone to help with a serious infection in his joint and bursa. While the infection improved, the horse developed complications at the injection site, including ongoing bone infection, worsening bone death, and eventually a broken bone. The findings suggest that the high dose of gentamicin may have harmed the bone cells. The researchers recommend using lower doses or different injection sites in the future to avoid these issues.
Abstract
OBJECTIVE: To describe and discuss previously unreported complications associated with intraosseous perfusion with gentamicin in horses. STUDY DESIGN: Case report. ANIMALS: Ten-year-old Warmblood gelding. METHODS: Intraosseous perfusion with gentamicin into the proximal phalanx (P1) was used as part of the treatment regimen for distal interphalangeal joint and navicular bursa synovial sepsis. Although the sepsis responded favorably complications developed at the perfusion site, including persistent osteomyelitis, progressive osteonecrosis, and ultimately pathologic fracture of P1. RESULTS: The progression of the clinical signs and findings at necropsy are suggestive of a toxic osteonecrosis secondary to intraosseous perfusion. CONCLUSIONS: Further work is needed to investigate the effects of high dose gentamicin on equine mesenchymal cells that may be achieved during intraosseous perfusion. CLINICAL RELEVANCE: Lower doses of perfusate within the medullary canal of P1 or alternative perfusion sites should be considered.
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Search related cases →Original publication: https://pubmed.ncbi.nlm.nih.gov/20459490/