Mayfield Cory K, Haglin Jack M, Konda Sanjit R, Tejwani Nirmal C, Egol Kenneth A
Keck School of Medicine of USC, Los Angeles, California.
Mayo Clinic School of Medicine, Scottsdale, Arizona.
JBJS Case Connect. 2019 Jul-Sep;9(3):e0297. doi: 10.2106/JBJS.CC.18.00297.
An 65-year-old immunocompetent female developed a Leclercia adecarboxylata infection following the repair of closed olecranon fracture. L. adecarboxylata is associated with polymicrobial infections, infections in immunocompromised patients and penetrating or open wounds. Following speciation, intravenous ceftriaxone was started. Two weeks later, the patient presented with leukopenia and neutropenia. Per infectious disease recommendations, the patient was switched to intravenous ertapenem with resolution of both infection and neutropenia. The olecranon fracture went on to heal fully.
This case describes a rare postoperative monomicrobial infection with L. adecarboxylata in an immunocompetent host following musculoskeletal trauma and identifies L. adecarboxylata as a potential emerging hospital-acquired pathogen following orthopedic surgery.
一名65岁免疫功能正常的女性在闭合性尺骨鹰嘴骨折修复后发生了去羧勒克菌感染。去羧勒克菌与混合感染、免疫功能低下患者的感染以及穿透性或开放性伤口有关。在鉴定出菌种后，开始静脉注射头孢曲松。两周后，患者出现白细胞减少和中性粒细胞减少。根据传染病专家的建议，将患者改用静脉注射厄他培南，感染和中性粒细胞减少均得到缓解。尺骨鹰嘴骨折最终完全愈合。
本病例描述了一例免疫功能正常的宿主在肌肉骨骼创伤后发生的罕见的术后去羧勒克菌单菌感染，并确定去羧勒克菌为骨科手术后一种潜在的新出现的医院获得性病原体。
