advertising
-
1.
Zhang P, Lu J, Jing Y, et al: Global epidemiology of diabetic foot ulceration: a systematic review and meta-analysis (dagger). Ann Med 49: 106, 2017.
-
2.
Moulik PK, Mtonga R, Gill GV: Amputation and mortality in new-onset diabetic foot ulcers stratified by etiology. Diabetes Care 26: 491, 2003.
-
3.
Lavery LA, Crisologo PA, La Fontaine J, et al: Are we misdiagnosing diabetic foot osteomyelitis? Is the gold standard gold? J Foot Ankle Surg 58: 713, 2019.
-
4.
Krentz AJ AP, Basu A, Kilvert A, et al: Morbidity and mortality associated with diabetic foot disease: A 12-month prospective survey of hospital admissions in a single UK centre. The Foot 7: 144, 1997.
-
5.
Liu X, Ren Q, Zhai Y, et al: Risk factors for multidrug-resistant organisms infection in diabetic foot ulcer. Infect Drug Resist 15: 1627, 2022.
-
6.
Gomez-Cerezo J, Suarez I, Rios JJ, et al: Achromobacter xylosoxidans bacteremia: a 10-year analysis of 54 cases. Eur J Clin Microbiol Infect Dis 22: 360, 2003.
-
7.
Crosby MD, Petropolis AA, Mackey VT, et al: An unusual skin infection with Achromobacter xylosoxidans. Cutis 106: 2110, 2020.
-
8.
Dubey L, Krasinski K, Hernanz-Schulman M: Osteomyelitis secondary to trauma or infected contiguous soft tissue. Pediatr Infect Dis J 7: 26, 1988.
-
9.
Hoddy DM, Barton LL: Puncture wound-induced Achromobacter xylosoxidans osteomyelitis of the foot. Am J Dis Child 145: 599, 1991.
-
10.
Stark JJ: Alcaligenes xylosoxidans osteomyelitis without trauma in a patient with Good's syndrome. Eur J Intern Med 18: 447, 2007.
-
11.
Ozer K, Kankaya Y, Baris R, et al: Calcaneal osteomyelitis due to Achromobacter xylosoxidans: a case report. J Infect Chemother 18: 915, 2012.
-
12.
Shinha T, Oguagha IC: Osteomyelitis caused by Achromobacter xylosoxidans. IDCases 2: 11, 2015.
-
13.
Pamuk G, Aygun D, Barut K, et al: Achromobacter causing a thrombophlebitis and osteomyelitis combination: a rare cause. BMJ Case Rep 2015: bcr2015210718, 2015.
-
14.
Monteiro-Soares M, Russell D, Boyko EJ, et al: Guidelines on the classification of diabetic foot ulcers (IWGDF 2019). Diabetes Metab Res Rev 36: e3273, 2020.
-
15.
Igra-Siegman Y, Chmel H, Cobbs C: Clinical and laboratory characteristics of Achromobacter xylosoxidans infection. J Clin Microbiol 11: 141, 1980.
-
16.
Marion-Sanchez K, Olive C, Platon MG, et al: Achromobacter xylosoxidans in hospital environments: still waters run deep! Trans R Soc Trop Med Hyg 114: 470, 2020.
-
17.
Pereira RH, Leao RS, Carvalho-Assef AP, et al: Patterns of virulence factor expression and antimicrobial resistance in Achromobacter xylosoxidans and Achromobacter ruhlandii isolates from patients with cystic fibrosis. Epidemiol Infect 145: 600, 2017.
-
18.
Hu Y, Zhu Y, Ma Y, et al: Genomic insights into intrinsic and acquired drug resistance mechanisms in Achromobacter xylosoxidans. Antimicrob Agents Chemother 59: 1152, 2015.
-
19.
Doi Y, Poirel L, Paterson DL, et al: Characterization of a naturally occurring class D beta-lactamase from Achromobacter xylosoxidans. Antimicrob Agents Chemother 52: 1952, 2008.
-
20.
Berbudi A, Rahmadika N, Tjahjadi AI, et al: Type 2 Diabetes and its impact on the immune system. Curr Diabetes Rev 16: 442, 2020.
-
21.
Tardáguila-García A, Sanz-Corbalán I, García-Alamino JM, et al: Medical versus surgical treatment for the management of diabetic foot osteomyelitis: a systematic review. J Clin Med 10: 1237, 2021.
-
22.
Musuuza J, Sutherland BL, Kurter S, et al: A systematic review of multidisciplinary teams to reduce major amputations for patients with diabetic foot ulcers. J Vasc Surg 71: 1433, 2020.
-
23.
Imani S, Wijetunga A, Shumborski S, et al: Chronic osteomyelitis caused by Achromobacter xylosoxidans following orthopedic trauma: A case report and review of the literature. ID Cases 25: e01211, 2021.
-
24.
Walsh JW, Hoffstad OJ, Sullivan MO, et al: Association of diabetic foot ulcer and death in a population-based cohort from the United Kingdom. Diabet Med 33: 1493, 2016.
Rare Case of Osteomyelitis Caused by Achromobacter xylosoxidans
Search for other papers by Christopher P. Girgis in
Current site
Google Scholar
PubMed
Search for other papers by Tyler L. Coye in
Current site
Google Scholar
PubMed
Search for other papers by Elizabeth Ansert in
Current site
Google Scholar
PubMed
Search for other papers by Amanda L. Killeen in
Current site
Google Scholar
PubMed
Search for other papers by Peter A. Crisologo in
Current site
Google Scholar
PubMed
Achromobacter xylosoxidans is a rare opportunistic aerobe that has rarely been documented in the literature as a causative agent for osteomyelitis. It can present with antibiotic resistance, making treatment without operative management challenging. We present the case of a 51-year-old male with a past medical history of uncontrolled type 2 diabetes. The patient presented to a clinic with a grade 2 infection to the right fifth digit, as defined by the International Working Group on the Diabetic Foot, and was subsequently admitted for intravenous antibiotics and operative management. Magnetic resonance imaging revealed abnormal signal of the phalanges of the fifth toe with sparing of the base of the proximal phalanx, consistent with osteomyelitis. An arthroplasty of the digit yielded pathology consistent with acute osteomyelitis and culture of Achromobacter xylosoxidans. Surgical debridement and culture-directed antibiotic therapy resulted in clinical cure. In chronic diabetic foot ulcerations, osteomyelitis should be considered, and Achromobacter xylosoxidans should be acknowledged as a potentially resistant organism. Therefore, it is paramount that a multidisciplinary approach is used when treating this condition.
advertising
