4.2 Article

Aeromonas hydrophilia-infected nonunion of a closed tibial fracture in a healthy adolescent: A case report

Journal

JOURNAL OF ORTHOPAEDIC SURGERY
Volume 29, Issue 2, Pages -

Publisher

SAGE PUBLICATIONS LTD
DOI: 10.1177/23094990211001587

Keywords

Aeromonas hydrophilia; closed fracture; induced membrane technique; infective nonunion; osteomyelitis

Funding

  1. National Cheng Kung University Hospital [NCKUH-10603023, NCKUH-10702024]

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Aeromonas hydrophilia can cause acute osteomyelitis and necrotizing fasciitis in otherwise healthy individuals; exposure to water is a risk factor for infection.
Aeromonas hydrophilia can cause soft tissue infection in both immunocompromised and healthy persons. A healthy 15-year-old adolescent fell into a ditch after a scooter accident and sustained a right distal tibial shaft closed fracture, a right femoral shaft closed fracture, and a dirty laceration over the medial aspect of the distal thigh above the right knee. 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. In an otherwise healthy patient with a closed fracture, Aeromonas hydrophilia can cause acute osteomyelitis and necrotizing fasciitis by spreading from a nearby contaminated wound. Exposure to water is a risk factor for Aeromonas hydrophilia infection.

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