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Dual Infection of an Open Fracture Caused by Mycobacterium setense and Clostridium celerecrescens

Infections caused by Mycobacterium setense or Clostridium celerecrescens are extremely rare. In this report, for the first time a dual infection with these two pathogens is described. An 18-year-old female suffered multiple injuries, including an open comminuted fracture of the right humeral diaphys...

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Autores principales: Ryskova, Lenka, Zahradnicek, Jan, Kukla, Rudolf, Bolehovska, Radka, Vajda, Milan, Pavlik, Ivo, Bostik, Pavel, Ryska, Pavel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495126/
https://www.ncbi.nlm.nih.gov/pubmed/36140033
http://dx.doi.org/10.3390/antibiotics11091254
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author Ryskova, Lenka
Zahradnicek, Jan
Kukla, Rudolf
Bolehovska, Radka
Vajda, Milan
Pavlik, Ivo
Bostik, Pavel
Ryska, Pavel
author_facet Ryskova, Lenka
Zahradnicek, Jan
Kukla, Rudolf
Bolehovska, Radka
Vajda, Milan
Pavlik, Ivo
Bostik, Pavel
Ryska, Pavel
author_sort Ryskova, Lenka
collection PubMed
description Infections caused by Mycobacterium setense or Clostridium celerecrescens are extremely rare. In this report, for the first time a dual infection with these two pathogens is described. An 18-year-old female suffered multiple injuries, including an open comminuted fracture of the right humeral diaphysis after falling from a fifth-floor balcony in January 2019. Five months after the accident, a fistula appeared in the scar, reaching the bone tissue. M. setense and C. celerecrescens were cultured from sinus swabs and subsequently from perioperative samples. The patient was initially treated with a combination of intravenous antibiotics (ATBs): imipenem, amikacin, and ciprofloxacin. One month after the fracture fixation with a titanium nail, C. celerecrescens was again detected; therefore, metronidazole was added to the therapy. A triple combination of oral (PO) ATBs (trimethoprim–sulfamethoxazole, moxifloxacin, and metronidazole) followed, 8 weeks after the initial intravenous therapy. C. celerecrescens was cultured again two times, most recently in November 2019, when surgical debridement was supplemented by the topical administration of cancellous bone impregnated with vancomycin. Signs of bone healing were found at follow-ups and ATB treatment was finished in March 2020 after a total of 9 months of therapy. To this day, there have been no signs of reinfection. This case thus illustrates the need for a combination of systemic and individualized local therapy in the treatment of complicated cases of dual infections with rare pathogens.
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spelling pubmed-94951262022-09-23 Dual Infection of an Open Fracture Caused by Mycobacterium setense and Clostridium celerecrescens Ryskova, Lenka Zahradnicek, Jan Kukla, Rudolf Bolehovska, Radka Vajda, Milan Pavlik, Ivo Bostik, Pavel Ryska, Pavel Antibiotics (Basel) Case Report Infections caused by Mycobacterium setense or Clostridium celerecrescens are extremely rare. In this report, for the first time a dual infection with these two pathogens is described. An 18-year-old female suffered multiple injuries, including an open comminuted fracture of the right humeral diaphysis after falling from a fifth-floor balcony in January 2019. Five months after the accident, a fistula appeared in the scar, reaching the bone tissue. M. setense and C. celerecrescens were cultured from sinus swabs and subsequently from perioperative samples. The patient was initially treated with a combination of intravenous antibiotics (ATBs): imipenem, amikacin, and ciprofloxacin. One month after the fracture fixation with a titanium nail, C. celerecrescens was again detected; therefore, metronidazole was added to the therapy. A triple combination of oral (PO) ATBs (trimethoprim–sulfamethoxazole, moxifloxacin, and metronidazole) followed, 8 weeks after the initial intravenous therapy. C. celerecrescens was cultured again two times, most recently in November 2019, when surgical debridement was supplemented by the topical administration of cancellous bone impregnated with vancomycin. Signs of bone healing were found at follow-ups and ATB treatment was finished in March 2020 after a total of 9 months of therapy. To this day, there have been no signs of reinfection. This case thus illustrates the need for a combination of systemic and individualized local therapy in the treatment of complicated cases of dual infections with rare pathogens. MDPI 2022-09-15 /pmc/articles/PMC9495126/ /pubmed/36140033 http://dx.doi.org/10.3390/antibiotics11091254 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Case Report
Ryskova, Lenka
Zahradnicek, Jan
Kukla, Rudolf
Bolehovska, Radka
Vajda, Milan
Pavlik, Ivo
Bostik, Pavel
Ryska, Pavel
Dual Infection of an Open Fracture Caused by Mycobacterium setense and Clostridium celerecrescens
title Dual Infection of an Open Fracture Caused by Mycobacterium setense and Clostridium celerecrescens
title_full Dual Infection of an Open Fracture Caused by Mycobacterium setense and Clostridium celerecrescens
title_fullStr Dual Infection of an Open Fracture Caused by Mycobacterium setense and Clostridium celerecrescens
title_full_unstemmed Dual Infection of an Open Fracture Caused by Mycobacterium setense and Clostridium celerecrescens
title_short Dual Infection of an Open Fracture Caused by Mycobacterium setense and Clostridium celerecrescens
title_sort dual infection of an open fracture caused by mycobacterium setense and clostridium celerecrescens
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9495126/
https://www.ncbi.nlm.nih.gov/pubmed/36140033
http://dx.doi.org/10.3390/antibiotics11091254
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