From Tooth to Phalanx: The First Reported Case of Porphyromonas endodontalis Causing Osteomyelitis of the Proximal Phalanx.

Porphyromonas (P.) species, typically associated with oral infections, are known for their role in causing root canal infections and endodontic abscesses. Here, the authors present the first and only reported case of P. endodontalis osteomyelitis in a long bone following a phalanx injury and subsequent dental procedure. In this case, the infection presented in the right fifth proximal phalanx of a 16-year-old boy. Despite initial conservative management and multiple negative bacterial cultures, symptoms persisted, prompting surgical intervention with debridement, biopsy, culture, and polymerase chain reaction analysis. This case underscores the aggressive and elusive nature of P. endodontalis, highlighting challenges in diagnosis and the importance of considering the Porphyromonas species in cases of osteomyelitis, particularly in those with a dental history.