Osteomielitis por Yokenella regensburgei luego de craneotomía en una paciente inmunocompetente

Abstract

Yokenella regensburgei es un bacilo Gram negativo de la familia Enterobacteriaceae, que puede encontrarse en agua de pozos, alimentos y en el tubo digestivo de insectos y reptiles. Aunque se ha aislado de muestras provenientes de seres humanos, pocas veces se ha reportado como causante de infección y, en tales casos, especialmente en pacientes inmunosuprimidos. Se presenta aquí el primer caso de osteomielitis secundaria a una infección por Y. regensburgei en una paciente inmunocompetente después de un procedimiento quirúrgico.Palabras clave: Enterobacteriaceae, osteomielitis. doi: http://dx.doi.org/10.7705/biomedica.v35i4.2719 Osteomyelitis due to Yokenella regensburgei following craniotomy in an immunocompetent patientThe gram-negative bacillus Yokenella regensburgei (of the Enterobacteriaceae family) can be found in groundwater and foodstuffs, as well as the digestive tracts of insects and reptiles. Although it has been isolated from humans since its original description, it has rarely been reported as a cause of infection, and then, only in immunosuppressed patients. We report the first case of post-surgical secondary osteomyelitis due to Y. regensburgei in an immunocompetent woman who had undergone a craniotomy.

Yokenella regensburgeiSepticemia in a Chinese Farmer Immunosuppressed by HIV: A Case Report and Literature Review

“…Y. regensburgei was isolated from his ulcerous wound and he was cured with ciprofloxacin. Penagos et al [12] presented a case of postsurgical secondary osteomyelitis due to Y. regensburgei in an immunocompetent woman who had undergone a craniotomy. The patient was successfully treated with ciprofloxacin for 42 days and there was no recurrence of infection at the end of 1-year follow-up.…”

Yokenella regensburgei, a novel pathogen in farmed American alligators

“…17 However, a record in a presumably immunocompetent human patient exists. 24 This bacterium has been isolated from a variety of human clinical specimens including synovial exudate, blood, cellulitis, urine, feces, and sputum, 29 and has been associated with soft-tissue infection with bacteremia, 17 septic arthritis and transient subclinical bacteremia, 1 venous ulcer, 6 osteomyelitis, 24 urinary tract infection, 26 respiratory tract infection, 7 digestive tract infection, 13 brain abscess, 25 and necrotizing fasciitis. 29 Alcoholic steatohepatitis and cirrhosis, infection with human immunodeficiency virus, immunosuppressive therapy, long-term renal disease, and diabetes mellitus have been listed as predisposing factors for Y. regensburgei infections in humans.…”

Yokenella regensburgei—Past, Present and Future

“…The earliest documented case of a musculoskeletal infection determined by Y. regensburgei infection was reported in 1994 from a septic knee [7]. Another case was described by Penagos et al in 2015 [38]. The patient presented with signs of osteomyelitis six weeks following surgical intervention of an invasive pituitary macroadenoma.…”

“…Ipsilateral eyelid ptosis and periorbital inflammation were observed. A postoperative infectious complication was presumed and, in this case, osteomyelitis was treated with cefazolin and clindamycin [38]. However, after the isolation of the bacteria from fluid collections in the epidural and subdural areas, the treatment regimen was changed to intravenous ciprofloxacin.…”