Atypical chronic osteomyelitis of femur post-traumatic post-implantation by Achromobacter denitrificans: A case report

Abstract

Background: The bacteria, Achromobacter are present ubiquitously in the moist environment. Infections due to Achromobacter have mostly been reported in immunocompromised patients. However, the microorganism has also been associated with nosocomial infections even in healthy subjects. Report: We report chronic osteomyelitis caused by Achromobacter denitrificans in a 44-year-old male with a history of femoral intramedullary nail in situ. The organism was confirmed by matrix assisted laser desorption ionization-time of flight mass spectrometry (MADI-TOF MS). Clinical management: The patient was managed with implant removal, surgical debridement and culture-directed antibiotic therapy that led to clinical cure. Conclusion: Identification of implant associated infection poses a serious challenge to surgeons and clinical microbiologists. Atypical pathogens must always be considered with a history of any implant in a case of chronic osteomyelitis.

Keywords

• Achromobacter denitrificans
• Chronic osteomyelitis
• Nosocomial
• Non-fermenter bacteria
• Atypical
• Fracture