MORGANELLA MORGANİİ’YE BAĞLI OSTEOMİYELİT: OLGU SUNUMU Osteomyelitis Due to Morganella Morganii: Case Report
Morganella morganii, insan normal florasında yer alan, fırsatçı bir mikroorganizmadır. Nadirensüpüratif kemik-eklem enfeksiyonlarına da neden olmaktadır. Elektrik akımına kapıldıktan sonrasol ayağı bilek hizasından ampütasyon yapılan 13 yaşındaki hastanın ateşi, güdük distalindehiperemi ve seröz akıntısı mevcuttu. Laboratuvar incelemesinde lökosit sayısı 11.270/mm3,Creaktifprotein 8,49 mg/dL, sedimentasyon 56 mm/saatti. Manyetik rezonans görüntülemesindekemik doku distal yarısında 5 cm mayi ve ödematöz değişiklikler saptandı. Debridman yapılıppiperasilin-tazobaktam ve amikasin tedavileri başlanan hastanın yara yeri kültüründe almaktaolduğu tedavilere hassas Morganella morganii üredi. Amikasin kesilerek piperasilin-tazobaktamtedavisine devam edilen hastaya ikinci haftada oral amoksisilin-klavulonat başlanarak tedavi süresitoplam 4 haftaya tamamlandı. Osteomiyelitte de diğer enfeksiyonlarda olduğu gibi, kesinpatojenin gösterilmesi, en uygun tedavinin seçilebilmesini ve bu sayede azalmış morbidite vemortaliteyi sağlayacaktır.Anahtar Sözcu¨kler: Çocuk; Morganella morganii; OsteomiyelitABSTRACTMorganella morganii is an opportunistic microorganism located in human normal flora. It rarelycauses suppurative bone-joint infections. A 13-year-old patent, who had amputation in the levelof the left wrist after receiving electric shock, had fever and hyperemia and serous discharge atdistal stump. In the laboratory study, leukocyte count was 11,270 / mm3, C-reactive protein was8.49 mg/dL, sedimentation was 56 mm/h. Magnetic resonance imaging revealed 5 cm liquidand edematous changes in the distal half of the bone tissue. Debridement and piperacillintazobactamand amikacin were started. The wound site culture grew Morganella morganii whichwas sensitive to the ongoing treatments. Piperacillin-tazobactam was continued and amikacinwas stopped. In the second week oral amoxicillin-clavulonate was started and the treatmentperiod was completed to 4 weeks. As with other infections in osteomyelitis, demonstration ofthe definitive pathogen will allow optimal selection of treatment and thus reduced morbidityand mortality.Keywords: Osteomyelitis; Child; Morganella morganii
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