Osteomyelitis Caused by Pantoea agglomerans in a Closed Fracture in a Child

Abstract

Development of osteomyelitis in a closed fracture is rare. Although it has been reported that trivial trauma may be associated with the subsequent development of acute osteomyelitis, no evidence has been found that fractures are involved in the etiology of osteomyelitis. Only 25 cases (11 in adolescents) of osteomyelitis after closed fracture have been reported in literature. The authors report a case of osteomyelitis in an 8-year-old girl after a forearm fracture involving the diaphysis of the radius and ulna. Radiographic examinations were performed 5, 14, and 30 days after trauma. At last examination, the forearm appeared swollen and red. Blood culture and radiographs confirmed the clinical suspicion of osteomyelitis. The cultures grew Pantoea agglomerans, a saprophytic gram-negative bacterium commonly isolated from plants, flowers, seeds, water, and soil and sensitive to all of the most common antibiotics. After the arm was immobilized, high doses of intravenous antibiotics were administered for 4 weeks, and oral antibiotics were prescribed for an additional 4 weeks. The patient responded well to treatment. Twelve months after the initial injury, the patient regained full elbow and wrist flexion-extension range of motion. Based on their experience and a review of the literature, the authors suggest that bone infection be considered for patients with closed fractures complicated by excessive or prolonged pain and swelling with evident signs of inflammation where no other obvious infection is apparent. Moreover, in children, bacterial infection may cause osteomyelitis more frequently than in adults, but no evidence exists that a closed fracture increases the incidence of osteomyelitis in children with a systemic infection.

Pantoea agglomerans as a Cause of Foreign Body Related Septic Arthritis in a Child: Case Report and Review of the Literature

“…When we reviewed the literature, there was one synovitis, seven osteomyelitis, one periostitis, and six septic arthritis cases caused by P. agglomerans described between 1978 and 2019 (►Table 1). [4][5][6][7][8][9][10][11][12] Thirteen of 15 patients were boys (88%) and median age was 7.4 years. In most cases, diagnosis was delayed 4 to 6 weeks after trauma because of the low virulence of the bacterium and late recognition of the foreign body.…”

Pantoea dispersa it the next emerging “monster” in our intensive care units? A case report and review of literature

“…In the words of researchers, “some species are plant pathogens while some are found in humans, especially Pantoea agglomerans . [ 6 ] It is noteworthy that, on the one hand, P. agglomerans is a well-documented human pathogen,[ 4 7 8 9 ] even reported to be a confirmed contaminant, isolated from consumed powdered infant formula milk in neonatal ICU ward, a first report from Iran,[ 10 ] while on the other hand, it is being used for the production of “Andrimid,” a newer, promising acetyl-CoA carboxylase inhibitor, a potent, broad-spectrum antibiotic! [ 11 ]…”

The Isolation and Identification of Bacteria on Feathers of Migratory Bird Species

“…The genus is frequently isolated from plant surfaces, seeds, soil, and water [53] and includes many species infective for humans. As reported by Delétoile et al [54], P. agglomerans , which is widely distributed in nature occupying, as preferential habitats, water, soil, and plants, is an opportunistic pathogen that causes numerous cases of infections to soft tissues and bones [55,56,57,58]. Marais et al [59] also reported on a rare case of cervical spondylodiscitis caused by P. agglomerans .…”