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Septic arthritis by Sphingobacterium multivorum in immunocompromised pediatric patient
OBJECTIVE: To report a case septic arthritis with a rare pathogen in a immunosuppressed child. CASE DESCRIPTION: Male patient, 6 years old, had liver transplant five and half years ago due to biliary atresia. Patient was using tacrolimus 1mg q.12h. This patient started to have pain in left foot and...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Sociedade de Pediatria de São Paulo
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5178126/ https://www.ncbi.nlm.nih.gov/pubmed/26915918 http://dx.doi.org/10.1016/j.rppede.2016.03.014 |
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author | Mendes, Maiana Darwich Cavallo, Rafael Ruiz Carvalhães, Cecilia Helena Vieira Franco Godoy Ferrarini, Maria Aparecida Gadiani |
author_facet | Mendes, Maiana Darwich Cavallo, Rafael Ruiz Carvalhães, Cecilia Helena Vieira Franco Godoy Ferrarini, Maria Aparecida Gadiani |
author_sort | Mendes, Maiana Darwich |
collection | PubMed |
description | OBJECTIVE: To report a case septic arthritis with a rare pathogen in a immunosuppressed child. CASE DESCRIPTION: Male patient, 6 years old, had liver transplant five and half years ago due to biliary atresia. Patient was using tacrolimus 1mg q.12h. This patient started to have pain in left foot and ankle and had one episode of fever 3 days before hospital admission. Physical examination showed weight 17kg, height 109cm, temperature 36.4°C, with pain, swelling and heat in the left ankle, without other clinical signs. Initial tests: hemoglobin 11.7g/dL hematocrit 36.4%, leukocyte count 17,600µL(-1) (7% banded neutrophils, 70% segmented neutrophils, 2% eosinophils, basophils 1%, 13% lymphocytes, 7% monocytes) C-reactive protein 170.88mg/L. Joint ultrasound showed moderate effusion in the site. Patient was submitted to surgical procedure and Sphingobacterium multivorum was isolated from the effusion. The germ was susceptible to broad spectrum cephalosporins (ceftriaxone and cefepime) and fluoroquinolones (ciprofloxacin and levofloxacin), and it was resistant to carbapenemic antibiotics and aminoglycosides. He was treated intravenously with oxacillin for 15 days and ceftriaxone for 13 days, and orally with ciprofloxacin for 15 days, with good outcome. COMMENTS: The S. multivorum is a gram negative bacillus that belongs to Flavobacteriaceae family and it is considered non-pathogenic. It has rarely been described as a cause of infections in humans, especially in hospital environment and in immunosuppressed patients. This case report is relevant for its unusual etiology and for the site affected, which may be the first case of septic arthritis described. |
format | Online Article Text |
id | pubmed-5178126 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | Sociedade de Pediatria de São Paulo |
record_format | MEDLINE/PubMed |
spelling | pubmed-51781262017-01-04 Septic arthritis by Sphingobacterium multivorum in immunocompromised pediatric patient Mendes, Maiana Darwich Cavallo, Rafael Ruiz Carvalhães, Cecilia Helena Vieira Franco Godoy Ferrarini, Maria Aparecida Gadiani Rev Paul Pediatr Case Reports OBJECTIVE: To report a case septic arthritis with a rare pathogen in a immunosuppressed child. CASE DESCRIPTION: Male patient, 6 years old, had liver transplant five and half years ago due to biliary atresia. Patient was using tacrolimus 1mg q.12h. This patient started to have pain in left foot and ankle and had one episode of fever 3 days before hospital admission. Physical examination showed weight 17kg, height 109cm, temperature 36.4°C, with pain, swelling and heat in the left ankle, without other clinical signs. Initial tests: hemoglobin 11.7g/dL hematocrit 36.4%, leukocyte count 17,600µL(-1) (7% banded neutrophils, 70% segmented neutrophils, 2% eosinophils, basophils 1%, 13% lymphocytes, 7% monocytes) C-reactive protein 170.88mg/L. Joint ultrasound showed moderate effusion in the site. Patient was submitted to surgical procedure and Sphingobacterium multivorum was isolated from the effusion. The germ was susceptible to broad spectrum cephalosporins (ceftriaxone and cefepime) and fluoroquinolones (ciprofloxacin and levofloxacin), and it was resistant to carbapenemic antibiotics and aminoglycosides. He was treated intravenously with oxacillin for 15 days and ceftriaxone for 13 days, and orally with ciprofloxacin for 15 days, with good outcome. COMMENTS: The S. multivorum is a gram negative bacillus that belongs to Flavobacteriaceae family and it is considered non-pathogenic. It has rarely been described as a cause of infections in humans, especially in hospital environment and in immunosuppressed patients. This case report is relevant for its unusual etiology and for the site affected, which may be the first case of septic arthritis described. Sociedade de Pediatria de São Paulo 2016 /pmc/articles/PMC5178126/ /pubmed/26915918 http://dx.doi.org/10.1016/j.rppede.2016.03.014 Text en © 2016 Sociedade de Pediatria de São Paulo. Published by Elsevier Editora Ltda http://creativecommons.org/licenses/by/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Case Reports Mendes, Maiana Darwich Cavallo, Rafael Ruiz Carvalhães, Cecilia Helena Vieira Franco Godoy Ferrarini, Maria Aparecida Gadiani Septic arthritis by Sphingobacterium multivorum in immunocompromised pediatric patient |
title | Septic arthritis by Sphingobacterium multivorum in immunocompromised pediatric patient |
title_full | Septic arthritis by Sphingobacterium multivorum in immunocompromised pediatric patient |
title_fullStr | Septic arthritis by Sphingobacterium multivorum in immunocompromised pediatric patient |
title_full_unstemmed | Septic arthritis by Sphingobacterium multivorum in immunocompromised pediatric patient |
title_short | Septic arthritis by Sphingobacterium multivorum in immunocompromised pediatric patient |
title_sort | septic arthritis by sphingobacterium multivorum in immunocompromised pediatric patient |
topic | Case Reports |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5178126/ https://www.ncbi.nlm.nih.gov/pubmed/26915918 http://dx.doi.org/10.1016/j.rppede.2016.03.014 |
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