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- Title
Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary.
- Authors
Chan Jing Er; Wong Kin Chun; Lim Ming Chiang; Mohd Nasir, Mohd Naim bin
- Abstract
Osteomyelits due to concurrent multi-drug resistance organisms is difficult to treat for any surgeon and infectious disease physician. An eleven-year-old boy presenting with an open fracture of the left radius and ulna after a fall in a stagnant wet field. Despite prophylactic antibiotics and surgical intervention, the open wound was infected, and Chromobacterium violaceum as well as Klebsiella pneumoniae were isolated. He was treated with six weeks of parenteral cefepime and amikacin and was discharged upon clinical improvement. Unfortunately, chronic osteomyelitis set in with persistent sinus drainage. He then underwent a second procedure for debridement of the wound and Burkholderia pseudomallei was isolated. Parenteral antibiotic therapy was initiated progressing with a marked improvement. However, the long course of antibiotics had exhausted the patient and his family, leading to a premature interruption of the parenteral antibiotic. Despite the suboptimal antibiotic course, there were no signs of relapsed osteomyelitis during subsequent review. The timely surgical intervention with appropriate sampling for subsequent microorganism isolation guided the suitability of the treatment line.
- Subjects
OSTEOMYELITIS; MULTIDRUG resistance; BURKHOLDERIA pseudomallei; CHROMOBACTERIUM violaceum; RADIUS fractures; COMPOUND fractures
- Publication
Revista do Instituto de Medicina Tropical de São Paulo, 2021, Vol 63, p1
- ISSN
0036-4665
- Publication type
Article
- DOI
10.1590/S1678-9946202163007