Key Words: Shewanella putrefaciens, osteomyelitis, metatarsophalangeal joint
Abstract
Shewanella putrefaciens is a Gram-negative bacillus and marine pathogen that rarely causes disease in humans. We report a case of osteomyelitis by this organism in a 48-year-old male patient, who presented with pain and erythema of the right foot that was initially diagnosed as cellulitis and did not revert despite treatment. He was transferred to Lima where osteomyelitis was diagnosed and started on empirical treatment with partial regression. A biopsy and culture of the compromised area found S. putrefaciens. The infection was treated according to the antibiotic sensitivity profile of the pathogen. S. putrefaciens infection represents a rare opportunistic infection of devitalized or exposed areas of the body. It is associated with residence in coastal areas and commonly affects the skin and soft tissues. Exceptional cases of osteomyelitis have been reported, but this is the first that involves the metatarsal bones.
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Shewanella putrefaciens es un bacilo Gram negativo, patógeno marino que rara vez ocasiona enfermedad en humanos. Se presenta un caso de osteomielitis por este microorganismo en un paciente varón de 48 años, procedente de Chimbote. Presentó dolor y eritema en el pie derecho, inicialmente diagnosticado como celulitis, pero que no revirtió pese al tratamiento. Fue transferido a Lima donde se diagnosticó osteomielitis e inició tratamiento empírico con escasa mejoría. Por ello, se realizó una biopsia y cultivo de la zona comprometida, el metatarso, en el cual se aisló Shewanella putrefaciens. Se trató de acuerdo al perfil de sensibilidad. La infección por Shewanella putrefaciens representa una rara infección oportunista, que se localiza en áreas desvitalizadas o expuestas del cuerpo. Se asocia a vivir en zonas costeras, afectando comúnmente piel y tejidos blandos. Se han reportado casos excepcionales de osteomielitis. Este es el primero que involucra metatarso.
Authors:
Katia Guinetti-Ortiz[1], Alejandra Bocanegra-Jesús[1], Andrea Gómez de la Torre-del Carpio[1]
Affiliation:
[1] Escuela de Medicina, Facultad de Ciencias de la Salud, Universidad Peruana de Ciencias Aplicadas, Perú
E-mail: katia.guinetti@gmail.com
Author address:
[1] Avenida Alameda San Marcos
Cuadra 2
Los Cedros de Villa
Chorrillos
Lima
Perú
Citation: Guinetti-Ortiz K, Bocanegra-Jesús A, Gómez de la Torre-del Carpio A. Osteomyelitis due to Shewanella putrefaciens: case report and literature review. Medwave 2016 Nov;16(10):6642 doi: 10.5867/medwave.2016.10.6642
Submission date: 23/8/2016
Acceptance date: 1/11/2016
Publication date: 29/11/2016
Origin: not requested
Type of review: reviewed by two external peer reviewers, double-blind
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- Holt HM, Gahrn-Hansen B, Bruun B. Shewanella algae and Shewanella putrefaciens: clinical and microbiological characteristics. Clin Microbiol Infect. 2005 May;11(5):347-52. | PubMed |
- Janda JM. Shewanella: a Marine Pathogen as an Emerging Cause of Human Disease. Clin Microbiol Newsl. 2014;36(4):25.9. | CrossRef |
- Botelho-Nevers E, Gouriet F, Rovery C, Paris P, Roux V, Raoult D, et al. First case of osteomyelitis due to Shewanella algae. J Clin Microbiol. 2005 Oct;43(10):5388-90. | PubMed |
- Vignier N, Barreau M, Olive C, Baubion E, Théodose R, Hochedez P, et al. Human infection with Shewanella putrefaciens and S. algae: report of 16 cases in Martinique and review of the literature. Am J Trop Med Hyg. 2013 Jul;89(1):151-6. | CrossRef | PubMed |
- Sharma KK, Kalawat U. Emerging infections: shewanella - a series of five cases. J Lab Physicians. 2010 Jul;2(2):61-5. | CrossRef | PubMed |
- Pope TL, Teague WG, Kossack R, Bray ST, Flannery DB. Pseudomonas sacroiliac osteomyelitis: diagnosis by gallium citrate Ga 67 scan. Am J Dis Child. 1982 Jul;136(7):649-50. | PubMed |
- Shimizu T, Matsumura Y. [A case of bacteremia and suppurative vertebral osteomyelitis/discitis due to Shewanella algae occurring after raw-fish consumption]. Kansenshogaku Zasshi. 2009 Sep;83(5):553-6. | PubMed |
- Gressier M, Mbayo D, Deramond H, Grados F, Eb F, Canarelli B. First case of human spondylodiscitis due to Shewanella algae. Int J Infect Dis. 2010 Sep;14 Suppl 3:e261-4. | CrossRef | PubMed |
- Carlson RM, Dux K. Shewanella putrefaciens, a rare cause of osteomyelitis. Int J Low Extrem Wounds. 2013 Sep;12(3):231-3. | CrossRef | PubMed |
- Sumathi BG, Kumarswamy SR, Amritam U, Arjunan R. Shewanella algae: First case report of the fast emerging marine pathogen from squamous cell carcinoma patient in India. South Asian J Cancer. 2014 Jul;3(3):188-9. | CrossRef | PubMed |
- Roblot F, Besnier JM, Juhel L, Vidal C, Ragot S, Bastides F, et al. Optimal duration of antibiotic therapy in vertebral osteomyelitis. Semin Arthritis Rheum. 2007 Apr;36(5):269-77. | PubMed |
- Leotau M, Villamizar H. Osteomielitis: Una revisión de la literatura. Rev Univ Salud. 2010;12(1):135-45. | Link |
- Hill SL, Holtzman GI, Buse R. The effects of peripheral vascular disease with osteomyelitis in the diabetic foot. Am J Surg. 1999 Apr;177(4):282-6. | PubMed |
- Brady RA, Leid JG, Calhoun JH, Costerton JW, Shirtliff ME. Osteomyelitis and the role of biofilms in chronic infection. FEMS Immunol Med Microbiol. 2008 Jan;52(1):13-22. | PubMed |
- Muñoz L, Vélez J, Molano D, Susunaga P, Gómez M. Pseudoquiste pancreático infectado por Shewanella putrefaciens. Reporte de un caso. Infect. 2015 Oct-Dec;19(4). | CrossRef |
Holt HM, Gahrn-Hansen B, Bruun B. Shewanella algae and Shewanella putrefaciens: clinical and microbiological characteristics. Clin Microbiol Infect. 2005 May;11(5):347-52. | PubMed |Janda JM. Shewanella: a Marine Pathogen as an Emerging Cause of Human Disease. Clin Microbiol Newsl. 2014;36(4):25.9. | CrossRef |Botelho-Nevers E, Gouriet F, Rovery C, Paris P, Roux V, Raoult D, et al. First case of osteomyelitis due to Shewanella algae. J Clin Microbiol. 2005 Oct;43(10):5388-90. | PubMed |Vignier N, Barreau M, Olive C, Baubion E, Théodose R, Hochedez P, et al. Human infection with Shewanella putrefaciens and S. algae: report of 16 cases in Martinique and review of the literature. Am J Trop Med Hyg. 2013 Jul;89(1):151-6. | CrossRef | PubMed |Sharma KK, Kalawat U. Emerging infections: shewanella - a series of five cases. J Lab Physicians. 2010 Jul;2(2):61-5. | CrossRef | PubMed |Pope TL, Teague WG, Kossack R, Bray ST, Flannery DB. Pseudomonas sacroiliac osteomyelitis: diagnosis by gallium citrate Ga 67 scan. Am J Dis Child. 1982 Jul;136(7):649-50. | PubMed |Shimizu T, Matsumura Y. [A case of bacteremia and suppurative vertebral osteomyelitis/discitis due to Shewanella algae occurring after raw-fish consumption]. Kansenshogaku Zasshi. 2009 Sep;83(5):553-6. | PubMed |Gressier M, Mbayo D, Deramond H, Grados F, Eb F, Canarelli B. First case of human spondylodiscitis due to Shewanella algae. Int J Infect Dis. 2010 Sep;14 Suppl 3:e261-4. | CrossRef | PubMed |Carlson RM, Dux K. Shewanella putrefaciens, a rare cause of osteomyelitis. Int J Low Extrem Wounds. 2013 Sep;12(3):231-3. | CrossRef | PubMed |Sumathi BG, Kumarswamy SR, Amritam U, Arjunan R. Shewanella algae: First case report of the fast emerging marine pathogen from squamous cell carcinoma patient in India. South Asian J Cancer. 2014 Jul;3(3):188-9. | CrossRef | PubMed |Roblot F, Besnier JM, Juhel L, Vidal C, Ragot S, Bastides F, et al. Optimal duration of antibiotic therapy in vertebral osteomyelitis. Semin Arthritis Rheum. 2007 Apr;36(5):269-77. | PubMed |Leotau M, Villamizar H. Osteomielitis: Una revisión de la literatura. Rev Univ Salud. 2010;12(1):135-45. | Link |Hill SL, Holtzman GI, Buse R. The effects of peripheral vascular disease with osteomyelitis in the diabetic foot. Am J Surg. 1999 Apr;177(4):282-6. | PubMed |Brady RA, Leid JG, Calhoun JH, Costerton JW, Shirtliff ME. Osteomyelitis and the role of biofilms in chronic infection. FEMS Immunol Med Microbiol. 2008 Jan;52(1):13-22. | PubMed |Muñoz L, Vélez J, Molano D, Susunaga P, Gómez M. Pseudoquiste pancreático infectado por Shewanella putrefaciens. Reporte de un caso. Infect. 2015 Oct-Dec;19(4). | CrossRef |
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