MORGANELLA MORGANİİ’YE BAĞLI OSTEOMİYELİT: OLGU SUNUMU Osteomyelitis Due to Morganella Morganii: Case Report
Abstract
Morganella morganii, insan normal florasında yer alan, fırsatçı bir mikroorganizmadır. Nadiren
süpüratif kemik-eklem enfeksiyonlarına da neden olmaktadır. Elektrik akımına kapıldıktan sonra
sol ayağı bilek hizasından ampütasyon yapılan 13 yaşındaki hastanın ateşi, güdük distalinde
hiperemi ve seröz akıntısı mevcuttu. Laboratuvar incelemesinde lökosit sayısı 11.270/mm3,Creaktif
protein 8,49 mg/dL, sedimentasyon 56 mm/saatti. Manyetik rezonans görüntülemesinde
kemik doku distal yarısında 5 cm mayi ve ödematöz değişiklikler saptandı. Debridman yapılıp
piperasilin-tazobaktam ve amikasin tedavileri başlanan hastanın yara yeri kültüründe almakta
olduğu tedavilere hassas Morganella morganii üredi. Amikasin kesilerek piperasilin-tazobaktam
tedavisine devam edilen hastaya ikinci haftada oral amoksisilin-klavulonat başlanarak tedavi süresi
toplam 4 haftaya tamamlandı. Osteomiyelitte de diğer enfeksiyonlarda olduğu gibi, kesin
patojenin gösterilmesi, en uygun tedavinin seçilebilmesini ve bu sayede azalmış morbidite ve
mortaliteyi sağlayacaktır.
Anahtar Sözcu¨kler: Çocuk; Morganella morganii; Osteomiyelit
ABSTRACT
Morganella morganii is an opportunistic microorganism located in human normal flora. It rarely
causes suppurative bone-joint infections. A 13-year-old patent, who had amputation in the level
of the left wrist after receiving electric shock, had fever and hyperemia and serous discharge at
distal stump. In the laboratory study, leukocyte count was 11,270 / mm3, C-reactive protein was
8.49 mg/dL, sedimentation was 56 mm/h. Magnetic resonance imaging revealed 5 cm liquid
and edematous changes in the distal half of the bone tissue. Debridement and piperacillintazobactam
and amikacin were started. The wound site culture grew Morganella morganii which
was sensitive to the ongoing treatments. Piperacillin-tazobactam was continued and amikacin
was stopped. In the second week oral amoxicillin-clavulonate was started and the treatment
period was completed to 4 weeks. As with other infections in osteomyelitis, demonstration of
the definitive pathogen will allow optimal selection of treatment and thus reduced morbidity
and mortality.
Keywords: Osteomyelitis; Child; Morganella morganii
References
- 1. Asmita D., Hirak J.R. and Prasanta K.M.Biofilm in Osteomyelitis caused by a Rare Pathogen, Morganella morganii : A Case Report.J Clin Diagn Res. 2016; 10: 06–08. 2. MikioN. , Masamitsu S., Yasuhiko M., Tomotsugu N. and Hideaki G. Giant Iliopsoas Abscess Caused by Morganella Morganii. Am J Case Rep. 2017; 18: 395–8. 3. Hui L. , Junmin Z. , Qiwen H., Xiancai R.Morganella morganii, a non-negligent opportunistic pathogen . International Journal of Infectious Diseases. 2016; 50: 10–7. 4. Matthias S., Michael N., Daniela S., Martin S., Georg S. and Tanja K.Osteomyelitis of the Patella in a 10-Year-Old Girl: A Case Report and Review of the Literature . Case Reports in Orthopedics. 2017: 6573271. 5. Chiappini E. Camposampiero C. ,Lazzeri S. , Indolfi G., De Martino M. and Galli L. Epidemiology and Management of Acute Haematogenous Osteomyelitis in a Tertiary Paediatric Center.Int. J. Environ. Res. Public Health. 2017; 14: 477. 6. Jialiang Z., Haifeng L., Feng L. , Yang M., Yang R. a , Yang L. et all. Severe chronic osteomyelitis caused by Morganella morganii with high population diversity. International Journal of Infectious Diseases .2016; 50: 44–7 7. Gurevich E., Tcher,nin D., Schreyber R., Muller R. and Leibovitz E. Follow-up after infants younger than 2 months of age with urinary tract infection in Southern Israel: epidemiologic, microbiologic and disease recurrence characteristics.Brazilian Journal of Infectious Diseases. 2016 ; 20:19-25 8. Demiray T., Akkaya Aydemir O., Koroglu M., Ozbek A. and Altindis M. A severe Morganella morganii endophthalmitis; followed by bacteremia Iran J Microbiol. 2016; 8: 70–2. 9. Legese MH., Weldearegay GM., Asrat D.Extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacteriaceae among Ethiopian children. Infect Drug Resist. 2017 ; 25: 27-34.
Abstract
References
- 1. Asmita D., Hirak J.R. and Prasanta K.M.Biofilm in Osteomyelitis caused by a Rare Pathogen, Morganella morganii : A Case Report.J Clin Diagn Res. 2016; 10: 06–08. 2. MikioN. , Masamitsu S., Yasuhiko M., Tomotsugu N. and Hideaki G. Giant Iliopsoas Abscess Caused by Morganella Morganii. Am J Case Rep. 2017; 18: 395–8. 3. Hui L. , Junmin Z. , Qiwen H., Xiancai R.Morganella morganii, a non-negligent opportunistic pathogen . International Journal of Infectious Diseases. 2016; 50: 10–7. 4. Matthias S., Michael N., Daniela S., Martin S., Georg S. and Tanja K.Osteomyelitis of the Patella in a 10-Year-Old Girl: A Case Report and Review of the Literature . Case Reports in Orthopedics. 2017: 6573271. 5. Chiappini E. Camposampiero C. ,Lazzeri S. , Indolfi G., De Martino M. and Galli L. Epidemiology and Management of Acute Haematogenous Osteomyelitis in a Tertiary Paediatric Center.Int. J. Environ. Res. Public Health. 2017; 14: 477. 6. Jialiang Z., Haifeng L., Feng L. , Yang M., Yang R. a , Yang L. et all. Severe chronic osteomyelitis caused by Morganella morganii with high population diversity. International Journal of Infectious Diseases .2016; 50: 44–7 7. Gurevich E., Tcher,nin D., Schreyber R., Muller R. and Leibovitz E. Follow-up after infants younger than 2 months of age with urinary tract infection in Southern Israel: epidemiologic, microbiologic and disease recurrence characteristics.Brazilian Journal of Infectious Diseases. 2016 ; 20:19-25 8. Demiray T., Akkaya Aydemir O., Koroglu M., Ozbek A. and Altindis M. A severe Morganella morganii endophthalmitis; followed by bacteremia Iran J Microbiol. 2016; 8: 70–2. 9. Legese MH., Weldearegay GM., Asrat D.Extended-spectrum beta-lactamase- and carbapenemase-producing Enterobacteriaceae among Ethiopian children. Infect Drug Resist. 2017 ; 25: 27-34.
Details
| Journal Section | Case Report |
|---|---|
| Authors | |
| Publication Date | December 13, 2017 |
| Published in Issue | Year 2017 Volume: 7 Issue: 4 |