Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary

Er, Chan Jing; Chun, Wong Kin; Chiang, Lim Ming; Nasir, Mohd Naim bin Mohd

doi:10.1590/s1678-9946202163007

Rev. Inst. Med. trop. S. Paulo

2021

DOI: 10.1590/s1678-9946202163007

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Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary

Chan Jing Er¹,

Wong Kin Chun²,

Lim Ming Chiang³

et al.

Abstract: This is an open-access article distributed under the terms of the Creative Commons Attribution License.

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2024

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Cited by 2 publications

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Chromobacterium violaceum infections in children: two case reports and literature review

Jiang,

Ren,

2024

Eur J Clin Microbiol Infect Dis

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Purpose Chromobacterium violaceum(C. violaceum) is a gram-negative bacterium that rarely infects humans, especially children. However, the mortality rate is high and there are no clear guidelines for treatment. The aim of this paper is to increase clinicians’ awareness of diseases caused by C. violaceum infections in children, to diagnose and treat them in a timely manner, to improve patient survival and to reduce mortality. Results We analysed the latest paediatric-related English language literature over the last 10 years and summarised the latest mechanisms of injury, susceptibility factors, adverse prognostic and mortality predictors, mortality rates, methods to reduce mortality, clinical manifestations, new diagnostic methods, therapeutic agents and directions for future drug development for C. violaceum. Conclusions Based on the available data, we conclude that the possibility of C. violaceum infection should be considered and diagnosed when cellulitis, septicaemia and visceral abscesses develop in children with a history of skin injury and exposure to stagnant water or soil. When clinicians strongly suspect that a child is infected with this bacterium, the recommended medication is ciprofloxacin if the child presents with severe illness. If the child has a non-severe condition, medications with relatively fewer side effects for children can be chosen, such as gentamicin, trimethoprim/ sulfamethoxazole, imipenem, and other drugs. The physician can then adjust the antimicrobial regimen based on the antimicrobial spectrum after obtaining the drug sensitivity results.

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Chromobacterium violaceum infections in children: two case reports and literature review

Jiang,

Ren,

2024

Eur J Clin Microbiol Infect Dis

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Severe Systemic Chromobacterium violaceum Infection: A Case Study of a German Long-Term Resident in French Guyana

Klenk,

Schnieders,

Heinemann

et al. 2024

TropicalMed

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Chromobacterium violaceum is a Gram-negative, facultative anaerobe proteobacterium. Its natural habitat is water and soil in tropical and subtropical regions. Human infections are characterized by rapid dissemination that can lead to high fatality rates. Here, we describe the first case of a C. violaceum infection reported from Germany. A German national with permanent residence in French Guyana contracted a C. violaceum infection presumably while bathing in a barrier lake in Brazil. The patient presented with a high fever and a crusty, erythematous skin lesion at an emergency department in Hamburg, Germany. Ultrasound and a CT scan of the abdomen revealed multiple liver abscesses. C. violaceum was detected in blood and from aspirates of the liver abscesses, using traditional culture methods and modern molecular assays. Prolonged treatment with meropenem and ciprofloxacin led to full recovery. Rapid pathogen detection and treatment initiation are of high importance in C. violaceum infections as mortality rates are overall declining but have still tended to reach up to 25% in recent years in systemic infections. Due to its broad natural drug resistance, antibiotic treatment is challenging. Increased travel activities may lead to more frequent presentation of patients with environmental pathogens of the tropics such as C. violaceum.

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Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary

Abstract: This is an open-access article distributed under the terms of the Creative Commons Attribution License.

Cited by 2 publications

References 12 publications

Chromobacterium violaceum infections in children: two case reports and literature review

Chromobacterium violaceum infections in children: two case reports and literature review

Severe Systemic Chromobacterium violaceum Infection: A Case Study of a German Long-Term Resident in French Guyana

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