First report of chronic implant-related septic arthritis and osteomyelitis due to Kytococcus schroeteri and a review of human K. schroeteri infections

Chan, Jasper Fuk‐Woo; Wong, S.P.; Leung, Sally S. M.; Fan, Ruifeng; Ngan, Antonio H. Y.; To, Kelvin Kai-Wang; Lau, Susanna K. P.; Yuen, Kwok‐Yung; Woo, Patrick C. Y.

doi:10.1007/s15010-012-0250-9

Cited by 20 publications

(14 citation statements)

References 21 publications

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“…Bacterial DNA extraction, PCR amplification, and 16S rRNA gene sequencing were performed as described in our previous publications for other Gram-positive cocci (3,4,5,6,7,8,9,10), with universal primers 1F (5=-AGTT TGATCMTGGCTCAG) and 2R (5=-GGACTACHAGGGTATCT AAT) as the PCR and sequencing primers. The sequences of the PCR products were compared with the sequences of closely related species in the GenBank database by multiple-sequence alignment with ClustalW (11).…”

Section: / Liter) Liver and Renal Function Test Results Were Unremarmentioning

confidence: 99%

First Report of Brain Abscess Caused by a Satelliting Phenotypic Variant of Helcococcus kunzii

2014

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Helcococcus kunzii was isolated from a brain abscess in a diabetic patient with cholesteatoma and demonstrated satellitism around Staphylococcus aureus in culture. This is the first reported case of severe central nervous system infection due to H. kunzii and the first description of a satelliting phenotypic variant of this organism. CASE REPORTA n 83-year-old man was admitted with a worsening right earache and fever for 10 days. He had a background history of hypertension, diabetes mellitus, and prostate cancer and was on androgen blockade therapy. On admission, he had a temperature of 37.2°C and a fluctuating consciousness level. Otoscopic examination revealed an inflamed outer ear canal. Blood tests showed leukocytosis (13.93 ϫ 10 9 /liter) with neutrophilia (12.19 ϫ 10 9 / liter). Liver and renal function test results were unremarkable. Contrast-enhanced computed tomography scans of the head showed a right-sided cholesteatoma with abscess formation in the mastoid cavity. There was no definite evidence of intracranial extension. Excision of the cholesteatoma and mastoidectomy were performed. Histology showed the presence of keratinized squamous metaplasia consistent with the preoperative diagnosis of cholesteatoma. Cultures of pus swabs obtained from the mastoid abscess were negative for bacterial and fungal growth.In view of the severe clinical infection with systemic upset, the head and neck surgeons in charge started the patient on intravenous ceftriaxone at 2 g every 12 h and intravenous metronidazole at 500 mg every 8 h for broad-spectrum coverage of Gram-negative pathogens, methicillin-sensitive Staphylococcus aureus, and anaerobes. Antipseudomonal coverage was to be added if the patient's condition did not improve. After 2 weeks of intravenous antibiotics, he showed clinical improvement and was switched to oral amoxicillin-clavulanate at 1 g twice daily. However, he developed generalized tonic-clonic convulsions and a high fever 3 weeks after the operation. Reassessment by computed tomography scans of the brain with contrast enhancement showed a right temporal brain abscess (Fig. 1). The abscess was drained surgically. Intravenous ceftriaxone at 2 g every 12 h and intravenous metronidazole at 500 mg every 8 h were restarted. In addition, intravenous vancomycin at 500 mg every 12 h (dose adjusted for estimated creatinine clearance) was commenced in view of breakthrough abscess formation despite previous broad-spectrum beta-lactam antibiotic use. Empirical local amikacin instillation was used to irrigate the abscess cavity through the abscess drain as described in the literature (1, 2). The patient's neurological status improved with no further seizure episodes. In view of the clinical improvement and the results of in vitro antimicrobial susceptibility testing of the bacterial isolate obtained from the brain abscess drainage at the second operation, he was kept on a regimen of ceftriaxone, vancomycin, and metronidazole. Local amikacin instillation through the abscess drain was discontinued. Subsequent c...

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Section: / Liter) Liver and Renal Function Test Results Were Unremarmentioning

confidence: 99%

First Report of Brain Abscess Caused by a Satelliting Phenotypic Variant of Helcococcus kunzii

2014

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“…Despite innovative treatment protocols developed during the last decades, posttraumatic fracture-related infection (FRI) is still associated with tremendous patient-related and socioeconomic issues in the clinical setting [1][2][3][4][5].…”

Section: Introductionmentioning

confidence: 99%

Treatment of fracture-related infection of the lower extremity with antibiotic-eluting ceramic bone substitutes: case series of 35 patients and literature review

et al. 2020

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Introduction The current treatment concepts of fracture-related infection (FRI) [Consensus Conference (Anti-Infection Task Force (AITF)) on the definition of acute or chronic osteomyelitis (cOM)] are associated with unsolved challenges and problems, underlining the need for ongoing medical research. Method Literature review of treatments for FRI and description of own cases. Results We could include eight papers with 394 patients reporting treatments and outcome in FRI. The infection was resolved in 92.9% (mean) of all treatments. The mean follow-up was 25 months with a persistent non-union in 7% of the patients. We diagnosed 35 (19f/16m; 56.4 ± 18.6 years) patients with bone infections anatomically allocated to the proximal and distal femur (12×), the pelvis (2×), distal tibia (3×), tibial diaphysis (11×), the ankle joint (4×) and calcaneus (3×). These 35 patients were treated (1) with surgical debridement; (2) with antibiotic-eluting ceramic bone substitutes; (3) bone stabilization (including nail fixation, arthrodesis nails, plates, or external ring fixation), (4) optionally negative pressure wound therapy (NPWT) and (5) optionally soft tissue closure with local or free flaps. The mean follow-up time was 14.9 ± 10.6 months (min/max: 2/40 month). The overall recurrence rate is low (8.5%, 3/35). Prolonged wound secretion was observed in six cases (17.1%, 6/35). The overall number of surgeries was a median of 2.5. Conclusion The results in the literature and in our case series are explicitly promising regarding the treatment of posttraumatic fracture-related infection.

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“…We believe the central venous catheter placement in our patient had a role in the development of this infection. There are several other cases of K. schroeteri infection that prove the bacterium has a propensity to favor synthetic material as a site of infection [ 1 , 5 , 6 ]. Our patient likely developed a central line associated blood stream infection and eventual seeding of the pulmonary tissue leading to pneumonia.…”

Section: Discussionmentioning

confidence: 99%

Kytococcus schroeteriBacteremia in a Patient with Hairy Cell Leukemia: A Case Report and Review of the Literature

Amaraneni

Malik

Jasra

et al. 2015

Case Reports in Infectious Diseases

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The Kytococcus genus formerly belonged to Micrococcus. The first report of a Kytococcus schroeteri infection was in 2002 in a patient diagnosed with endocarditis. We report a case of central line associated Kytococcus schroeteri bacteremia in a patient with underlying Hairy Cell Leukemia. Kytococcus schroeteri is an emerging infection in the neutropenic population and in patients with implanted artificial tissue. It is thought to be a commensal bacterium of the skin; however, attempts to culture the bacteria remain unsuccessful. There have been a total of 5 cases (including ours) of K. schroeteri bacteremia in patients with hematologic malignancies and neutropenia and only 18 documented cases in any population. Four of the cases of bacteria in neutropenic patients have been fatal, but early detection and treatment could make a difference in clinical outcomes.

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First report of chronic implant-related septic arthritis and osteomyelitis due to Kytococcus schroeteri and a review of human K. schroeteri infections

Cited by 20 publications

References 21 publications

First Report of Brain Abscess Caused by a Satelliting Phenotypic Variant of Helcococcus kunzii

First Report of Brain Abscess Caused by a Satelliting Phenotypic Variant of Helcococcus kunzii

Treatment of fracture-related infection of the lower extremity with antibiotic-eluting ceramic bone substitutes: case series of 35 patients and literature review

Kytococcus schroeteriBacteremia in a Patient with Hairy Cell Leukemia: A Case Report and Review of the Literature

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