Mandibular osteomyelitis due to Raoultella species

Abstract

IntroductionRaoultella is a genus of aerobic Gram-negative bacilli belonging to the family Enterobacteriaceae that are commonly found in water, soil and aquatic environments. With improved bacterial identification techniques, Raoultella species (namely R. planticola and R. ornithinolytica) have been an increasingly reported cause of infections in humans.Case presentationAn 85-year-old man presented to hospital with a several-week history of left jaw pain and trismus. His medical history was significant for left mandibular osteomyelitis treated 1 year previously with amoxicillin-clavulanate. On admission, a computed tomography scan demonstrated a 2.6×1.7×1.6 cm peripherally enhancing collection surrounding the left posterior mandibular body. Two aspirates of the abscess grew a bacterium belonging to the genus Raoultella, with discordant species identification (R. ornithinolytica versus R. planticola) using two different techniques. A potential source of infection included a left lower molar tooth which was extracted months preceding the original diagnosis of osteomyelitis.ConclusionThis is the first case of mandibular osteomyelitis caused by Raoultella species reported in the literature. In contrast to other forms of osteomyelitis, the pathogenesis of mandibular osteomyelitis involves contiguous spread from an odontogenic focus. Risk factors for mandibular osteomyelitis include a history of fracture, irradiation, diabetes and steroid therapy. This report adds to the growing literature of infections caused by this genus of bacteria, and raises the possibility of this organism’s role in odontogenic infections.

Evolution of shelf life parameters of ready-to-eat escarole (Cichorium endivia var. latifolium) subjected to different cutting operations

“…The first species is reported to cause bacteremia in adult and paediatric patients (Kamath et al, 1992). Raoultella ornithinolytica is a member of the Enterobacteriaceae family commonly found in water, soil and aquatic environments that is being increasingly isolated from humans where it can determine infections of the urinary tract (Lam et al, 2018).…”

Maxillary Osteomyelitis with an Incidental Diagnosis of Maxillary Diffuse Large B-Cell Lymphoma: A Case Report

“…Only one prior case of osteomyelitis caused by R. planticola has been reported, with diagnostic studies in this case also suggesting the presence of R. ornithinolytica [8]. Only one prior case of osteomyelitis secondary to R. ornithinolytica has been reported previously [8]. In addition to identification by traditional body fluid (blood, urine, sputum, etc.)…”

“…The most frequently reported infections included bacteremia, pneumonia, urinary tract infections including cystitis and prostatitis, skin and soft tissue infections such as cellulitis and necrotizing fasciitis and intra-abdominal infections such as cholangitis, cholecystitis, pancreatitis, and gastroenteritis [7]. Only one prior case of osteomyelitis caused by R. planticola has been reported, with diagnostic studies in this case also suggesting the presence of R. ornithinolytica [8]. Only one prior case of osteomyelitis secondary to R. ornithinolytica has been reported previously [8].…”

CTX-M-9 group ESBL-producing Raoultella planticola nosocomial infection: first report from sub-Saharan Africa

“…urinary tract, gastrointestinal tract, respiratory tract) or at surgical sites. Bacteraemia, osteomyelitis, meningitis, cerebral abscess, mediastinitis, pericarditis, conjunctivitis, mandibular osteomyelitis and otitis caused by Raoultella have also been reported [20,21]. In general, the most common microorganisms isolated from SSIs after small bowel surgery are aerobic Gram-negative enteric bacteria [14].…”