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Case Reports
. 2019 Apr 23;19(1):333.
doi: 10.1186/s12879-019-3979-2.

Surgical wound infection following open humeral fracture caused by Mycobacterium houstonense: a case report

Lei Tian  1 , Zhen Zhang  2 , Zhongju Chen  1 , Ziyong Sun  3
Affiliations
Case Reports

Surgical wound infection following open humeral fracture caused by Mycobacterium houstonense: a case report

Lei Tian et al. BMC Infect Dis. .

Abstract

Background: Historically Mycobacterium houstonense belongs to the unnamed third biovariant complex of the Mycobacterium fortuitum group, which are sorbitol positive. To date, there have been few reports of human infection induced by M. houstonense worldwide.

Case presentation: We describe the case of a 68-year-old man with surgical wound infection, following an open humeral fracture, caused by M. houstonense and Escherichia coli. An implant bone plate had been embedded for internal fixation during surgery on the humeral fracture previously. A week later E. coli was isolated from the skin wound secretions. Cefoperazone-sulbactam was used for treatment for two weeks but the infection was not controlled, with a subsequent risk of deep wound infection. External fixation of the fracture was then performed instead of internal fixation. Ten days later, M. houstonense was isolated from new wound secretions. M. houstonense was identified by the molecular sequencing method. The TREK Diagnostic System was used to test the susceptibility to antibiotics by the microbroth dilution method. Levofloxacin and amikacin were used for treatment according to the results of the susceptibility test and the patient's condition obviously improved.

Conclusion: To the best of our knowledge, this is the first case in China of human surgical wound infection caused by M. houstonense following open humeral fracture. The combination of levofloxacin and amikacin was effective in the treatment of M. houstonense infection.

Keywords: Escherichia coli; Microbroth dilution method; Mycobacteria houstonense; Mycobacterium fortuitum group; TREK diagnostic systems.

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Conflict of interest statement

Ethics approval and consent to participate

The study protocol was approved by the Tongji Hospital ethics committee for research in health. Informed written consent was obtained from the patient.

Consent for publication

The patient provided written consent for the case details to be published.

Competing interests

The authors declare that they have no competing interest.

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Figures

Fig. 1
Fig. 1
Large bone defects in the middle and lower part of the humerus
Fig. 2
Fig. 2
Implant bone plate was embedded for internal fixation
Fig. 3
Fig. 3
External fixation of fracture were done
Fig. 4
Fig. 4
Secretion was seen in the wound
See this image and copyright information in PMC

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