Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary
Autor(a) principal: | |
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Data de Publicação: | 2021 |
Outros Autores: | , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Revista do Instituto de Medicina Tropical de São Paulo |
Texto Completo: | https://www.revistas.usp.br/rimtsp/article/view/184085 |
Resumo: | 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. |
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Revista do Instituto de Medicina Tropical de São Paulo |
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Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandaryOsteomyelitisMulti-drug resistance (MDR) organismsBurkholderia pseudomalleiChromobacterium violaceumOsteomyelits 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.Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo2021-01-29info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionapplication/pdfhttps://www.revistas.usp.br/rimtsp/article/view/18408510.1590/s1678-9946202163007 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e7Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e7Revista do Instituto de Medicina Tropical de São Paulo; v. 63 (2021); e71678-99460036-4665reponame:Revista do Instituto de Medicina Tropical de São Pauloinstname:Instituto de Medicina Tropical (IMT)instacron:IMTenghttps://www.revistas.usp.br/rimtsp/article/view/184085/170523Copyright (c) 2021 Chan Jing Er, Wong Kin Chun, Lim Ming Chiang, Mohd Naim bin Mohd Nasirhttps://creativecommons.org/licenses/by-nc/4.0info:eu-repo/semantics/openAccessEr, Chan Jing Chun, Wong KinChiang, Lim Ming Nasir, Mohd Naim bin Mohd 2022-05-16T13:44:35Zoai:revistas.usp.br:article/184085Revistahttp://www.revistas.usp.br/rimtsp/indexPUBhttps://www.revistas.usp.br/rimtsp/oai||revimtsp@usp.br1678-99460036-4665opendoar:2022-12-13T16:52:56.451284Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT)true |
dc.title.none.fl_str_mv |
Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary |
title |
Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary |
spellingShingle |
Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary Er, Chan Jing Osteomyelitis Multi-drug resistance (MDR) organisms Burkholderia pseudomallei Chromobacterium violaceum |
title_short |
Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary |
title_full |
Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary |
title_fullStr |
Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary |
title_full_unstemmed |
Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary |
title_sort |
Pediatric osteomyelitis due to rare tropical multi-drug resistance (MDR) organisms: a treatment quandary |
author |
Er, Chan Jing |
author_facet |
Er, Chan Jing Chun, Wong Kin Chiang, Lim Ming Nasir, Mohd Naim bin Mohd |
author_role |
author |
author2 |
Chun, Wong Kin Chiang, Lim Ming Nasir, Mohd Naim bin Mohd |
author2_role |
author author author |
dc.contributor.author.fl_str_mv |
Er, Chan Jing Chun, Wong Kin Chiang, Lim Ming Nasir, Mohd Naim bin Mohd |
dc.subject.por.fl_str_mv |
Osteomyelitis Multi-drug resistance (MDR) organisms Burkholderia pseudomallei Chromobacterium violaceum |
topic |
Osteomyelitis Multi-drug resistance (MDR) organisms Burkholderia pseudomallei Chromobacterium violaceum |
description |
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. |
publishDate |
2021 |
dc.date.none.fl_str_mv |
2021-01-29 |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/184085 10.1590/s1678-9946202163007 |
url |
https://www.revistas.usp.br/rimtsp/article/view/184085 |
identifier_str_mv |
10.1590/s1678-9946202163007 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
https://www.revistas.usp.br/rimtsp/article/view/184085/170523 |
dc.rights.driver.fl_str_mv |
Copyright (c) 2021 Chan Jing Er, Wong Kin Chun, Lim Ming Chiang, Mohd Naim bin Mohd Nasir https://creativecommons.org/licenses/by-nc/4.0 info:eu-repo/semantics/openAccess |
rights_invalid_str_mv |
Copyright (c) 2021 Chan Jing Er, Wong Kin Chun, Lim Ming Chiang, Mohd Naim bin Mohd Nasir https://creativecommons.org/licenses/by-nc/4.0 |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
application/pdf |
dc.publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
publisher.none.fl_str_mv |
Universidade de São Paulo. Instituto de Medicina Tropical de São Paulo |
dc.source.none.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e7 Revista do Instituto de Medicina Tropical de São Paulo; Vol. 63 (2021); e7 Revista do Instituto de Medicina Tropical de São Paulo; v. 63 (2021); e7 1678-9946 0036-4665 reponame:Revista do Instituto de Medicina Tropical de São Paulo instname:Instituto de Medicina Tropical (IMT) instacron:IMT |
instname_str |
Instituto de Medicina Tropical (IMT) |
instacron_str |
IMT |
institution |
IMT |
reponame_str |
Revista do Instituto de Medicina Tropical de São Paulo |
collection |
Revista do Instituto de Medicina Tropical de São Paulo |
repository.name.fl_str_mv |
Revista do Instituto de Medicina Tropical de São Paulo - Instituto de Medicina Tropical (IMT) |
repository.mail.fl_str_mv |
||revimtsp@usp.br |
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1798951653126176768 |