Introduction:
Neisseria elongata, a gram-negative rod, has been identified in 23 cases of pathogenesis in the literature, of which only 2 were osteomyelitis. Here we report the third known case of isolated N. elongata cultures in a digital osteomyelitis.
Presentation of case:
A 63-year-old male with peripheral vascular disease and lower extremity wounds presented to his vascular surgeon with right-handed redness and pain requiring urgent surgical intervention. Irrigation, debridement, and partial thumb amputation were performed, followed by treatment with a 6-week course of antibiotics.
Discussion:
N. elongata is a rare cause of osteomyelitis and unfamiliarity with the causal organism and rod-like morphology may delay diagnosis and treatment.
Conclusion:
Gram-negative coverage should be considered in high-risk populations with cellulitis to prevent progression to fulminant abscesses, suppurative tenosynovitis and osteomyelitis.