Management of tibial fracture complicated with Aeromonas hydrophilic infection:A rare case

After empiric antibiotics and radical debridement of the contaminated wound, a femoral interlocking nail and tibial external fixator were applied. However, acute osteomyelitis later presented in his femur and tibia, and Aeromonas hydrophilia grew in cultures from the knee wound and the fracture sites. During the follow-up, his tibia became an infected nonunion, and was successfully treated with the induced membrane technique.

"Wounds exposed to a moist environment carry the risk of Aeromonas hydrophilia infection. Therefore, in our practice, an open fracture with exposure to water is managed with an external fixator, broad-spectrum empiric antibiotics, and urgent, thorough debridement. If there are signs of rapid progressive soft tissue infection, Aeromonas hydrophilia should be considered as one of the possible leading pathogens. Third or fourth generation cephalosporin in combination with a tetracycline or gentamicin, piperacillin-tazobactam, or fluoroquinolone are choices of empiric antibiotics for suspicious Aeromonas hydrophilia soft tissue infection, while a susceptibility test for all Aeromonas isolates is highly recommended as their potential of resistance to ESBLs, AmpC cephalosporinases, carbapenemases, and ciprofloxacin."the team opined.

For full article follow the link:https://journals.sagepub.com/doi/full/10.1177/23094990211001587

Primary source: Journal of Orthopaedic Surgery