Puncture Wound—Induced Achromobacter xylosoxidans Osteomyelitis of the Foot FREE

DAVID M. HODDY, MD; LESLIE L. BARTON, MD

Am J Dis Child. 1991;145(6):599-600. doi:10.1001/archpedi.1991.02160060015006.

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ABSTRACT

ABSTRACT | REFERENCES

Sir.—Achromobacter xylosoxidans is a gram-negative bacteria, found in the vertebrate intestinal tract and isolated from aqueous environments. The majority of infections caused by A xylosoxidans are either nosocomially acquired or involve immunocompromised hosts, but sporadic communityacquired infections in presumed normal patients have been described.¹

Osteomyelitis of the foot following puncture wounds through sneakers is most often associated with Pseudomonas aeruginosa or other Pseudomonas species.^2-4 We describe a child with community-acquired A xylosoxidans osteomyelitis of the foot that resulted from a puncture wound.

Patient Report.—A previously healthy 11-year-old boy stepped on two nails 2.5 weeks before seeking care. The nails penetrated his tennis shoe to a presumed depth of about 2 inches. Immediately after the injury, the foot was soaked in hydrogen peroxide and alcohol. The wounds initially appeared to be healing well without evidence of drainage, pain, or swelling. In the week before admission the child

REFERENCES

ABSTRACT | REFERENCES

Mandell WF, Garvey GJ, Neu HC. Achromobacter xylosoxidans bacteremia . Rev Infect Dis. 1987;;9:1001-1005.

Fisher MC, Goldsmith JF, Gilligan PH. Sneakers as a source of Pseudomonas aeruginosa in children with osteomyelitis following puncture wounds . J Pediatr. 1985;;106:607-609.

Rowley AH, Dias LD, Chadwick EG, Shulman ST. Pseudomonas stutzeri: an unusual case of calcaneal Pseudomonas osteomyelitis . Pediatr Infect Dis J. 1987;;6:296-297.

Baltimore RS, Jenson HB. Puncture wound osteochondritis caused by Pseudomonas maltophilia . Pediatr Infect Dis J. 1990;;9:143-144.

Kiredjian M, Holmes B, Kersters K, Guilvout I, DeLey J. Alcaligenespiechaudii: a new species from human clinical specimens and the environment . Int J Syst Bacteriol . 1986;;36:282-287.

Dubey L, Krasinski K, Hernanz-Schulman M. Osteomyelitis secondary to trauma or infected contiguous soft tissue . Pediatr Infect Dis J. 1988;;7:26-34.

Jacobs RF, McCarthy RE, Elser JM. Pseudomonas osteochondritis complicating puncture wounds of the foot in children: a 10 year evaluation . J Infect Dis. 1989;;160:657-661.

Schoch PE, Cunha BA. Nosocomial Achromobacter xylosoxidans infections . Infect Control Hosp Epidemiol. 1988;; 9:84-87.

Joseph WS, LeFrock JL. Infections complicating puncture wounds of the foot . J Foot Surg. 1987;;26:S30-S33.

Mackowiak PA, Jones SR, Smith JW. Diagnostic value of sinus-tract cultures in chronic osteomyelitis . JAMA . 1978;;239:2772-2775.

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