MORGANELLA MORGANİİ’YE BAĞLI OSTEOMİYELİT: OLGU SUNUMU Osteomyelitis Due to Morganella Morganii: Case Report

Öz

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

Anahtar Kelimeler

• MORGANELLA MORGANİİ’YE BAĞLI OSTEOMİYELİT: OLGU SUNUMU Osteomyelitis Due to Morganella Morganii: Case Report

Kaynakça

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