Infection in the Tropics: A Complex Case Study From Bronze Age (1200–700  <scp>bc</scp> ) Thailand

ABSTRACT The tropical environment is well known for harboring a significant and diverse pathogen load. The aim of this study is to present a Bronze Age (1200–700 bc ) case from northeast Thailand in which the incomplete skeleton of a young woman exhibited diffuse osteolytic and osteoblastic lesions spanning the periosteum, cortex, and medullary cavity in the right radius, ulna, and distal humerus. Detailed descriptions from macroscopic and radiographic observations are provided for each lesion. While not a simple case, it is suggested that osteomyelitis from a contiguous cutaneous injury is the most parsimonious diagnosis that may well have contributed to her premature death. This case discusses the range of possible tropical pathogens relevant to the social and environmental context. Alongside land clearance, rice farming, animal husbandry, and hunting and gathering, it is perhaps surprising that there is very little skeletal evidence of infectious disease, including osteomyelitis, identified in prehistoric communities from Thailand to date. The over 1000 burials excavated in the Mun River Valley of northeast Thailand warrant further attention.