Molecular diagnosis and enrichment culture identified a septic pseudoarthrosis due to an infection with Erysipelatoclostridium ramosum

We describe here a rare case of septic pseudarthrosis due to Erysipelatoclostridium ramosum in a female young patient. The patient, currently in remission from Ewing’s sarcoma treated by a bone resection and allograft combined with chemotherapy, suffered from a chronic femoral pseudarthrosis in a context of bone insufficiency and graft resorption. A broad range 16S PCR followed by sequencing, as well as an enrichment culture of a bone biopsy revealed the presence of E. ramosum, an anaerobic firmicute with a low Gram-positive affinity staining and low GC content, that was further characterized by whole genome sequencing (WGS). Keywords: Clostridium ramosum, Erysipelatoclostridium ramosum, Pseudoarthrosis, Graft resorption, Bone insufficiency, Taxogenomics, Bacterial genomics