Pathological fracture in acute osteomyelitis of long bones secondary to community-acquired methicillin-resistant Staphylococcus aureus: two cases and review of the literature.

Pathologic fracture is a rare complication of acute bacterial osteomyelitis in adults. Community-acquired methicillin-resistant Staphylococcus aureus (CA-MRSA) has been increasingly reported in skin and soft tissue and systemic infections in children and adults, including many cases of osteomyelitis. We recently treated two adult patients with acute osteomyelitis of long bones secondary to CA-MRSA complicated by a pathologic fracture. In both patients, the primary source of dissemination to the bone was a skin and soft tissue infection. We speculate that virulence factors specific for CA-MRSA currently circulating in the United States may predispose to a complicated course of acute osteomyelitis.