MORGANELLA MORGANİİ'YE BAĞLI OSTEOMİYELİT: OLGU SUNUMU

Morganella morganii, insan normal florasında yer alan, fırsatçı bir mikroorganizmadır. Nadiren süpüratif kemik-eklem enfeksiyonlarına da neden olmaktadır. Elektrik akımına kapıldıktan sonra sol ayağı bilek hizasından ampütasyon yapılan 13 yaşındaki hastanın ateşi, güdük distalinde hiperemi ve seröz akıntısı mevcuttu. Laboratuvar incelemesinde lökosit sayısı 11.270/mm3,Creaktif protein 8,49 mg/dL, sedimentasyon 56 mm/saatti. Manyetik rezonans görüntülemesinde kemik doku distal yarısında 5 cm mayi ve ödematöz değişiklikler saptandı. Debridman yapılıp piperasilin-tazobaktam ve amikasin tedavileri başlanan hastanın yara yeri kültüründe almakta olduğu tedavilere hassas Morganella morganii üredi. Amikasin kesilerek piperasilin-tazobaktam tedavisine devam edilen hastaya ikinci haftada oral amoksisilin-klavulonat başlanarak tedavi süresi toplam 4 haftaya tamamlandı. Osteomiyelitte de diğer enfeksiyonlarda olduğu gibi, kesin patojenin gösterilmesi, en uygun tedavinin seçilebilmesini ve bu sayede azalmış morbidite ve mortaliteyi sağlayacaktır.

Osteomyelitis Due to Morganella Morganii: Case Report

Morganella morganii is an opportunistic microorganism located in human normal flora. It rarely causes suppurative bone-joint infections. A 13-year-old patent, who had amputation in the level of the left wrist after receiving electric shock, had fever and hyperemia and serous discharge at distal stump. In the laboratory study, leukocyte count was 11,270 / mm3, C-reactive protein was 8.49 mg/dL, sedimentation was 56 mm/h. Magnetic resonance imaging revealed 5 cm liquid and edematous changes in the distal half of the bone tissue. Debridement and piperacillintazobactam and amikacin were started. The wound site culture grew Morganella morganii which was sensitive to the ongoing treatments. Piperacillin-tazobactam was continued and amikacin was stopped. In the second week oral amoxicillin-clavulonate was started and the treatment period was completed to 4 weeks. As with other infections in osteomyelitis, demonstration of the definitive pathogen will allow optimal selection of treatment and thus reduced morbidity and mortality.

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