Tibial Osteomyelitis Caused By Gordonia Bronchialis In An Imuunocompetent Patient: A Case Report

1352 words - 5 pages

A 22 year old healthy, immunocompetent female with no past medical history underwent an arthroscopic knee surgery for a left anterior cruciate ligament and left lateral meniscal tears following a sport related injury. She had a reconstruction with hamstring auto graft from the same leg and a partial meniscectomy. 3 months after the surgery, she developed 2 areas of erythema, swelling, and pain around the harvest incision site with small abscess formation which was draining purulent discharge. She was afebrile with no systemic symptoms. At that time, she was seen at an urgent care facility and was prescribed bactrim for which she developed an allergic reaction a week after. Subsequently, she was seen at the orthopedic clinic for lack of improvement of her localized symptoms. She underwent incision and drainage of the abscess, and some bloody fluid was drained and sent for cultures. Meanwhile, she was started on Augmentin 825 mg po bid for 2 weeks. The culture grew branching gram-positive bacilli, which were sent out for further identification. Preliminary results reported possible nocardia species. However, later on, it turned out to be Gordonia bronchiali. She continued to have pain and drainage from 2 small openings just below the knee so it was decided to go for surgical debridement. The patient had an excisional debridement of the bone and hardware removal. She had an absorbable screw, which was in the tibial tunnel. The debridement was not done to the level of the knee joint. Tissue cultures again grew Gordonia bronchialis. The patient was put on Vancomycin empirically after the surgical debridement until the susceptibilities came back. The bacterium was sensitive to all tested antibiotics including amikacin, amoxicillin, clavulanate, ceftriaxone, ciprofloxacin, clarithromycin, doxycycline, imipenem, linezolid, minocycline, moxifloxacin, Bactrim, and tobramycin. Thus, patient was switched to oral Ciprofloxacin for 4 weeks after which the wound healed completely. There was no drainage or redness. Patient remained asymptomatic afterwards with no sings of recurrent infection.
Discussion:
Gordonia species are aerobic actinomycetes that rarely infect humans, often in the setting of intravascular catheter infections. Gordonia related Infections usually affect immunocompromised and rarely occur in immunocompetent patients [1]. In 1971, the Gordonia genus was differentiated from other aerobic actinomycetes [2]. Few reports of different infections due to several Gordonia species have been reported in recent years. A study in Thailand reported 171 aerobic actinomycetes isolates sent to the National Institute of Health for identification between 1996 and 2003, of which 6 % were Gordonia species [3]. Different types of infections caused by Gordonia species have been reported in the literature, including, but not limited to, sternal wound infections, otitis externa, skin and soft tissue infections [4, 5, 6, 7]. The species isolated in our...

Find Another Essay On Tibial Osteomyelitis caused by Gordonia Bronchialis in an Imuunocompetent patient: a case report

Harm Caused by Tourism in Africa

1305 words - 5 pages away from the whole experience. Cheetahs are an endangered species because they are hunted by poachers for their skins and the African government has not cracked down on the problem enough. This has caused a drop in their population so there are almost no truly wild cheetahs left. Part of traveling around Tanzania also included going to animal sanctuaries where sick animals are kept. One of the sanctuaries that I visited was for giraffes and

Harm Caused by Steroids in the MLB

747 words - 3 pages denounced any link to abusing the muscle enhancing drugs. In an interview with 60 Minutes on February 13, 2005, Jose Canseco an all-star player back in his day, admitted that he would never have been a major league-caliber player without using the drugs. Then there are famous players like Mark Mcguire, and Barry Bonds who have been exploited by others for using steroids, but repeatedly deny the accusations. In a recent ESPN.com poll, 93% said that

Drug related crime: a distinction between crimes rooted in prohibition and crimes caused by drug use

2938 words - 12 pages that when held accountable for their actions, criminals will often attempt to portray themselves as victims of drugs, and that their crimes were solely caused by their drug use . However in every case encountered, a drug dependant person will have been involved in crime prior to commencing the use of drugs .A 1996 Australian report has also conceded that the drug-crime nexus "is difficult to establish since the motives for offending are many and

The Decline in Morality Has Caused an Increase in Crime

1324 words - 5 pages banding together in the face of crisis. Therefore, crime was in large part caused by a breakdown of morality. Since 1965, the crime rate has steadily risen. In the same period, faith a moral integrity has waned. We have told people there are no absolutes and that they are not responsible for their own behavior. They are simply victims of a system that isn't working anymore and they don't have to worry about it because the government is going to

An book report about les miserable in a political fashion.

2307 words - 9 pages her as a nuisance. Although this was an extreme case, some parents still mistreat their children. Today a common example of abuse is hitting a child. Ms. Hart, a mother of 5, used a spatula to hit her children if they didn't hurry up in the morning. ("Patching Up the Parents": 1F+) Fortunately there are Child Protective Services who investigate abusive parents and if they are in fact abusive the children are taken away and put into a better home

Ecology Lab Report: Creating an Ecosystem in a Bottle

2524 words - 10 pages Objective: To create an ecosystem contained in a bottle with both terrestrial and aquatic environments sealed to the outside world. Hypothesis/Predictions: I predict the fish will last for 3 days. I predict the crickets will last for a week. Materials: 1. fish 2. Water 3. 2 plants 4. Soil 5. Rag

This case study is in regards to Starbucks' international expansion strategy. It describes the advantages and risks which may be caused by expansion to Europe

6965 words - 28 pages manipulators, but easily explained in Starbucks' case. Highcoffee prices depressed margins, but were publicly discussed by Starbucks and havebeen incorporated into analysts expectations, relieving the need for manipulation.n An AQI of .498 shows that the amount of "soft" assets on Starbucks' books isdecreasing and the quality of its assets is increasing.n A SGI of 1.497 indicates that Starbucks' sales grew by almost 50 percent last year. Ahigh SGI

Climate Change is Here: Argumentative essay in favor of a view of climate change that has been caused by humans.

1038 words - 4 pages Climate Change is HereOver the last 50 years, scientists have compiled research and data that have concluded that the global temperature is rising. The question that remains is whether "Global Climate Change" is caused by nature or by man. Some believe that human emissions from the burning of fossil fuels are to blame and that they are causing the temperatures to rise. Others feel that there is no human influence and it is part of a natural

A Poem Analysis: "A Noiseless Patient Spider" by Walt Whitman

1640 words - 7 pages body, as wellas of nature, as a vehicle in this process, his method is similar to Emerson's.Using the spider-web metaphor suggested by Emerson, Whitman explainsin the last five lines of "A Noiseless Patient Spider" the situation of his ownpoetic soul and what that soul attempts to do. Whitman's poetic soul, like thespider stands isolated at the center of things. If it is to take on meaning, itmust, as Emerson put it, "come to a ripeness of

RBS computer failure 'caused by inexperienced operative in India'

2150 words - 9 pages . Then, every company that doing outsourcing, they cannot 100% relies on the outsourcing company. They must have a top management that controls the operation in the outsourcing company in order maintain top performance and indirectly it can prevent the company from getting losses. (1,811 words) References Furness, H. (2012). ‘RBS computer failure 'caused by inexperienced operative in India'. The Telegraph [Online] available from

RBS Computer Failure ‘Caused by Inexperienced Operative in India’

3419 words - 14 pages INTRODUCTION Case study is about computer failures that occurred at Royal Bank of Scotland due to inexperienced operative in India. this has resulted in millions of customers unable to access their account simply because of a mistake made by a technician. This issue occurs when the software upgraded is implemented. All programming staff at RBS admits that matters is occurred because they have been based in Hyderabad, India. Based on technology

Similar Essays

A Case Study In The Pharmacological Regime Of An Aids Patient

3181 words - 13 pages regime:The standard dosage initially is 200 mg po q 4hrs, and after 1 month, 100 mg po q 4hrs. Zidovudine is available in capsule, syrup, and IV preparations.Applications to case studyIt can be confirmed that Rodney has a CD4 count less than 500. The dose, scheduling and route of administration comply with standards (if preceded by an initial first month at higher dosage). Records are not available to confirm this. It is usual to commence treatment

Assess The View That Inflation Is Always Caused By An Increase In Aggregate Demand

641 words - 3 pages 'Assess the view that inflation is always caused by an increase in aggregate demand'In order to address this question it is first necessary to define both inflation and aggregate demand. Aggregate Demand is the total amount demanded by the whole economy, ie it is not related to one single market. Inflation is the persistent increase in the average level of consumer prices compared to the same time the previous year. This is a natural occurrence

Assess The View That Inflation Is Always Caused By An Increase In Aggregate Demand

641 words - 3 pages 'Assess the view that inflation is always caused by an increase in aggregate demand'In order to address this question it is first necessary to define both inflation and aggregate demand. Aggregate Demand is the total amount demanded by the whole economy, ie it is not related to one single market. Inflation is the persistent increase in the average level of consumer prices compared to the same time the previous year. This is a natural occurrence

A Case Report Of Lowe Syndrome Diagnosed By Linkage Analysis

1232 words - 5 pages estimated that around one person is affected by this genetic disease within a pool of around five million among the gene pools of Caucasian, Caspian and the Nordic races according to the report of the French Lowe Association.It has been formulated that this disorder, OCLR, is recognized early in childhood. A diagnosis of OCRL was made at age 9 years in our patient, relying on bilateral congenital cataracts, mental retardation, growth delay and the