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CASE REPORT
Osteomyelitis caused by co-infection of Citrobacter freundii and Morganella morganii following soil exposure – Case Report and Clinical Insights
1
Department of Dermatology, 4th Affiliated Hospital of Southwest Medical University (TIANFU Affiliated Hospital), China
2
Orthopaedics Department, Renshou County Traditional Chinese Medicine Hospital, China
3
Department of Neurology, 4th Affiliated Hospital of Southwest Medical University, China
Corresponding author
Yang Xu
Department of dermatology, The Fourth Affiliated Hospital of Southwest Medical University (TIANFU Affiliated Hospital), China
Department of dermatology, The Fourth Affiliated Hospital of Southwest Medical University (TIANFU Affiliated Hospital), China
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Soil harbours diverse bacteria and antibiotic resistance genes. This report describes a rare co-infection with Citrobacter freundii (C. freundii) and Morganella morganii (M. morganii) causing hand osteomyelitis in an elderly farmer, highlighting dynamic pathogen shifts and management challenges.
Case Report:
An 85-year-old farmer developed a thumb felon after fieldwork. Treatment failure and non-compliance led to progression. Despite repeated drainage and antibiotics, osteomyelitis developed. Sequential cultures showed a shift from C. freundii to M. morganii. Distal thumb amputation was ultimately required, resulting in permanent disability.
Results and Conclusions:
Soil exposure can cause sequential polymicrobial infections. Inadequate treatment disrupts local ecology, favouring resistant bacteria. Dynamic microbiological monitoring is essential. A strategy of ‘continuous monitoring + ecological antimicrobial selection + proactive MDT involvement’ is recommended for high-risk individuals.
Soil harbours diverse bacteria and antibiotic resistance genes. This report describes a rare co-infection with Citrobacter freundii (C. freundii) and Morganella morganii (M. morganii) causing hand osteomyelitis in an elderly farmer, highlighting dynamic pathogen shifts and management challenges.
Case Report:
An 85-year-old farmer developed a thumb felon after fieldwork. Treatment failure and non-compliance led to progression. Despite repeated drainage and antibiotics, osteomyelitis developed. Sequential cultures showed a shift from C. freundii to M. morganii. Distal thumb amputation was ultimately required, resulting in permanent disability.
Results and Conclusions:
Soil exposure can cause sequential polymicrobial infections. Inadequate treatment disrupts local ecology, favouring resistant bacteria. Dynamic microbiological monitoring is essential. A strategy of ‘continuous monitoring + ecological antimicrobial selection + proactive MDT involvement’ is recommended for high-risk individuals.
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| eISSN: | 1898-2263 |
| ISSN: | 1232-1966 |
Generation of the DOI (Digital Object Identifier) - task financed under the agreement No NrRCN/SP/0532/2021/1 by the Minister of Science and Higher
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