Musculoskeletal infections associated with Citrobacter koseri

• Published in: Annals of the Royal College of Surgeons of England 2016-09, Vol.98 (7), p.446-449
• Main Authors: Kwaees, T A, Hakim, Z, Weerasinghe, C, Dunkow, P
• Format: Article
• Language: English
• Subjects: Aged; Arthralgia - microbiology; Arthritis, Infectious - diagnosis; Arthritis, Infectious - microbiology; Arthroscopy; Citrobacter koseri; Enterobacteriaceae Infections - diagnosis; Enterobacteriaceae Infections - microbiology; Humans; Knee Joint - microbiology; Male; Musculoskeletal Diseases - microbiology; Pediatrics; Review
• ISSN: 0035-8843; 1478-7083
• DOI: 10.1308/rcsann.2016.0209

Introduction Citrobacter koseri is a well known cause of central nervous system infections in the paediatric setting. Musculoskeletal infections caused by C koseri are rare, with only 14 previously reported cases. We present the first recorded case of C koseri induced septic arthritis of the knee along with a review of the literature. Methods A search of the PubMed, Embase(®) and Google Scholar™ databases was undertaken. Only complete or near complete cases were reviewed. Findings Fourteen musculoskeletal infections were identified. Of these, five were associated with an operative procedure and five involved a septic joint. Surgical treatment was required in the majority of cases and cure was achieved in all cases following prolonged antibiotic use. Conclusions C koseri associated musculoskeletal infections may complicate primary orthopaedic procedures. The organism can present aggressively and can be difficult to identify microbiologically. It is sensitive to newer generation beta-lactams, cephalosporin-based antibiotics and timely surgery.