Pathological Fracture of the Right Distal Radius Caused by Enterobacter aerogenes Osteomyelitis in an Adult

Lin, Te‐Yu; Chi, Hung-Wei; Wang, Ning‐Chi

doi:10.1097/maj.0b013e3181d94f90

Cited by 5 publications

(7 citation statements)

References 9 publications

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“…Of the full-text articles, 37 were excluded further due to incomplete GNB speciation and non-standard microbiologic test procedures reported in the articles. We, thus, included 251 articles for this review ( 18 – 76 , 78 – 103 , 105 – 245 , 247 – 246 ); of these, 124 were case series reports and 127 were hospital microbiologic survey reports.…”

Section: Methodsmentioning

confidence: 99%

Infections Caused by Antimicrobial Drug-Resistant Saprophytic Gram-Negative Bacteria in the Environment

Raphael

Riley

2017

Front. Med.

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BackgroundDrug-resistance genes found in human bacterial pathogens are increasingly recognized in saprophytic Gram-negative bacteria (GNB) from environmental sources. The clinical implication of such environmental GNBs is unknown.ObjectivesWe conducted a systematic review to determine how often such saprophytic GNBs cause human infections.MethodsWe queried PubMed for articles published in English, Spanish, and French between January 2006 and July 2014 for 20 common environmental saprophytic GNB species, using search terms “infections,” “human infections,” “hospital infection.” We analyzed 251 of 1,275 non-duplicate publications that satisfied our selection criteria. Saprophytes implicated in blood stream infection (BSI), urinary tract infection (UTI), skin and soft tissue infection (SSTI), post-surgical infection (PSI), osteomyelitis (Osteo), and pneumonia (PNA) were quantitatively assessed.ResultsThirteen of the 20 queried GNB saprophytic species were implicated in 674 distinct infection episodes from 45 countries. The most common species included Enterobacter aerogenes, Pantoea agglomerans, and Pseudomonas putida. Of these infections, 443 (66%) had BSI, 48 (7%) had SSTI, 36 (5%) had UTI, 28 (4%) had PSI, 21 (3%) had PNA, 16 (3%) had Osteo, and 82 (12%) had other infections. Nearly all infections occurred in subjects with comorbidities. Resistant strains harbored extended-spectrum beta-lactamase (ESBL), carbapenemase, and metallo-β-lactamase genes recognized in human pathogens.ConclusionThese observations show that saprophytic GNB organisms that harbor recognized drug-resistance genes cause a wide spectrum of infections, especially as opportunistic pathogens. Such GNB saprophytes may become increasingly more common in healthcare settings, as has already been observed with other environmental GNBs such as Acinetobacter baumannii and Pseudomonas aeruginosa.

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Section: Methodsmentioning

confidence: 99%

Infections Caused by Antimicrobial Drug-Resistant Saprophytic Gram-Negative Bacteria in the Environment

Raphael

Riley

2017

Front. Med.

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“…The majority is found in the lower limb, which is supported in a series of chronic osteomyelitis 20 yrs after childhood skeletal traction therapy within management of lower limb fractures in children [12]. Some rare complications without relation to trauma has been seen in the distal radius in elderly diabetic patients are osteomyelitis and pathological fractures [13] and in the ulna with growth of Salmonella typhi [14]. Osteomyelitis as a rare complication of complex distal radius fractures has been seen if the initial treatment included bone grafting [15,16].…”

Section: Discussionmentioning

confidence: 99%

“…Lin TY et al [13] Pathological fracture of the right distal radius caused by Enterobacter aerogenes osteomyelitis in an adult. Complicated cases such as these are often limited in their management options.…”

Section: Discussionmentioning

confidence: 99%

Brodie’s Abscess 7 Years after External Fixation of a Displaced Distal Radius Fracture: A Case Report and Review of the Literature

Lindau¹,

Oestreich²

2015

MOJOR

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This case report and review of the literature present a rare long-term complication after a closed displaced distal radius fracture operated on with closed reduction and external fixation (EF). There were no early problems except a malunion without impairment. Seven years later the patient presented with a Brodie's abscess; i.e. deep osteomyelitis at one of the previous EF pin sites. Brodie's osteomyelitis often has a subtle and atypical presentation. X-rays may demonstrate an intraosseous bone lesion. Diagnosis is often made through MRI and/or nuclear bone scans. Standard treatment is operative excision of the lesion with curettage, insertion of antibiotic beads and appropriate antibiotics based upon curettage of the cyst and microbiological findings. We followed these principals and had an excellent outcome.

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“…A 13-year old Ugandan boy with chronic osteomyelitis because of Mycotic aneurysm infection experienced a pathological fracture of the femur [ 20 ]. Lin et al (2010) reported a case of pathological fracture of the right distal radius for a 79-year old male patient with Enterobacter aerogenes osteomyelitis [ 21 ]. Döring et al (2016) found recently that the displaced neck of femur fracture for an old patient was associated with chronic osteomyelitis of the ipsilateral foot.…”

Section: Introductionmentioning

confidence: 99%

Population study evaluating fracture risk among patients with chronic osteomyelitis

Sung

Mou

et al. 2017

PLoS ONE

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BackgroundStudies investigating the fracture risk in patients with chronic osteomyelitis (COM) limited to case reports. This study evaluated the association between COM and subsequent fracture risk using population-based data.MethodsA subset claims data of the Taiwan National Health Insurance was used to identify 7,147 patients with COM newly diagnosed in 1999–2005 without fracture history and 28,588 general population controls, frequency matched by sex, age and diagnosis date. The incident fractures was measured by the end of 2013.ResultsThe incidence density of fracture was 1.94-fold greater in the COM cohort than in controls (21.5 vs. 11.1 per 1000 person-years), with the adjusted hazard ratio (HR) of 1.81 (95% CI: 1.67–1.95) for COM patients compared to controls after controlling for sex, age, and comorbidities of diabetes, osteoporosis, depression and end-stage renal disease in Cox proportional hazards regression. The fracture risk increased with age and women were at greater risk than men. The fracture incidence increased substantially in those with osteoporosis, 40.2 per 1000 person-years in COM patients. Site specific analysis showed a higher portion of incident fractures for lower limbs, 52.7% in COM cohort and 46.3% in controls.ConclusionFindings in this 15-year follow-up observation support our hypothesis that patients with COM are at an elevated risk of subsequent fracture. COM patients and the elderly deserve adequate consultation and awareness for fracture prevention.

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Pathological Fracture of the Right Distal Radius Caused by Enterobacter aerogenes Osteomyelitis in an Adult

Cited by 5 publications

References 9 publications

Infections Caused by Antimicrobial Drug-Resistant Saprophytic Gram-Negative Bacteria in the Environment

Infections Caused by Antimicrobial Drug-Resistant Saprophytic Gram-Negative Bacteria in the Environment

Brodie’s Abscess 7 Years after External Fixation of a Displaced Distal Radius Fracture: A Case Report and Review of the Literature

Population study evaluating fracture risk among patients with chronic osteomyelitis

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