Cleveland Clinic Journal of Medicine (CCJM)Brodie Abscess in an 87-year-old Man

A Case Study Highlights the Importance of Timely Diagnosis and Treatment in Preventing Complications

An 87-year-old man’s journey from a misdiagnosis of a bone tumor to a late-stage Brodie abscess reinforces the critical need for healthcare professionals to be vigilant in diagnosing and treating this rare form of osteomyelitis, particularly in older adults.

Key Points:

• An 87-year-old man initially presented with dull pain below his right knee and was misdiagnosed with a bone tumor.
• One year later, the patient was admitted to the hospital with elevated inflammatory markers and a sinus tract connecting the tibial lesion to subcutaneous tissue.
• Methicillin-resistant Staphylococcus aureus (MRSA) was cultured from the abscess, confirming a case of Brodie abscess.
• The patient underwent surgical debridement and a 4-week course of intravenous vancomycin, followed by a 3-month course of oral minocycline.
• Brodie abscess is a rare form of subacute or chronic osteomyelitis, most commonly affecting the tibia.
• The standard treatment involves surgical debridement and systemic antibiotic therapy.
• Delay in treatment can lead to complications like sinus tracts, fistulas, or bone fractures.
• Relapse rates are approximately 15% for Brodie abscess and 20% for chronic osteomyelitis.

Brodie abscess was first described in 1832 by Sir Benjamin Collins Brodie, making it one of the earliest recognized forms of osteomyelitis.

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