Musculoskeletal infections associated with Citrobacter koseri

Ann R Coll Surg Engl. 2016 Sep;98(7):446-9. doi: 10.1308/rcsann.2016.0209. Epub 2016 Jul 14.

Abstract

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.

Keywords: Arthroscopy; Citrobacter koseri; Periprosthetic infection; Septic arthritis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • 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*