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Streptococcus pneumoniae Osteomyelitis in a 25-Year-Old Man as the Initial Presentation of Multiple Myeloma

A Case Report

Webber, Tracy, MD1,a; Lawlor, Michael, MD, PhD2; Balach, Tessa, MD3

doi: 10.2106/JBJS.CC.16.00272
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Case: We report the case of a 25-year-old man with femoral Streptococcus pneumoniae pyomyositis as well as hypercalcemia, mild anemia, and elevated inflammatory markers; he subsequently was diagnosed with immunoglobulin G (IgG) kappa multiple myeloma.

Conclusion: Multiple myeloma most commonly affects patients who are >60 years of age, and causes clinical symptoms from anemia, lytic bone lesions, hypercalcemia, and renal failure. These findings and a monoclonal protein spike serve as initial diagnostic and treatment criteria. Multiple myeloma is associated with susceptibility to bacterial infections, especially encapsulated organisms; however, this is rarely the initial presentation. Additionally, it is unusual for myeloma to be diagnosed in a young person (<40 years of age).

1Department of Orthopaedic Surgery, University of Connecticut, Farmington, Connecticut

2Department of Infectious Disease, Hartford Hospital, Hartford, Connecticut

3Department of Orthopaedic Surgery, University of Chicago Medicine & Biological Science, Chicago, Illinois

aE-mail address for T. Webber: twebber5@gmail.com

Copyright © 2017 by The Journal of Bone and Joint Surgery, Incorporated
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