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Category: Volume 07 Issue 03 March 2019
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Title: Citrobacter Koseri osteomyelitis of maxilla- A Rarity

Authors: Dr Payal Nanwani, Dr Vrinda Kolte, Dr Ramakrishna Shenoi

 DOI: https://dx.doi.org/10.18535/jmscr/v7i3.89

Abstract

Introduction

Citrobacter is gram-negative aerobic bacilli belonging to Enterobacteriaceae. C. diversus (C. koseri), C. amalonaticus and C. freundii are three major species in the genus. Citrobacter species mostly causes urinary tract and gastrointestinal infections.1 These usually affect immunocompromised hosts, geriatric patients, neonates as well as cause nosocomial infections.2 Citrobacter  koseri (diversus) causes meningitis and brain abscess besides sepsis in neonates.3

Citrobacter osteomyelitis is an uncommon condition. There are only few septic arthritis and osteomyelitis cases reported due to Citrobacter species.4,5 Citrobacter Osteomyelitis in the geriatric patients often results from direct invasion of soft tissue infection because of vascular compromise such as diabetes mellitus and bone cultures may yield mixed microorganisms.4,5Bone cultures should be evaluated to detect probable pathogens and determine proper antimicrobial therapy.2

Osteomyelitis of maxilla was originally described by Rees in 1847.6 Osteomyelitis of facial bones is unusual condition. Osteomyelitis of maxilla is uncommon as compared to that of mandible because of extensive blood supply and strut like bone of maxilla makes it less prone to chronic infection.1,7

Here we report a case of Citrobacter koseri osteomyelitis in an elderly diabetic patient affecting maxilla. The concerned literature is reviewed and discussed.

References

  1. Karthik Shamanna, Rasika Rao, Asima Banu. Osteomyelitis of Maxilla: A Rare Case. Journal of Public Health Medicine Research 2014; 2(1):50-2.
  2. Server Yagcia, Kader Arslana, Zeliha Kocak Tufana, Sami Kiniklia, Ali Pekcan Demiroza. Osteomyelitis Due to Citrobacter koseri Infection in a Diabetic Patient. Journal of Clinical Endocrinology and Metabolism 2011; 1(3):146-48.
  3. Murray PR. Enterobacteriaceae. In: P.R. Murray, editor. Medical microbiology, Philadelphia: Mosby Elsevier; 2009. p. 301-14.
  4. Kleint W, Herwig H. Septic osteomyelitis caused by Citrobacter with a contribution to the problem of cortisone administration in bacterial infections. Arztl Wochensch 1958; 13(43):965-69.
  5.  Jansen RD, Meadow WL, Schwartz IK, Ogata ES. “Bacteriological bit”: Citrobacter diversus osteomyelitis in a neonate. Clinical Pediatrics (Phila) 1981; 20(12):791.
  6. S P Lumba, A Nirola, B S Grewal. Healed osteomyelitis of Maxilla with tooth in the floor of nose. The Journal of Laryngology & Otology Aug 1971; 85[08]:877-9.
  7. Manimaran K, Suresh Kannan P, Kannan R. Osteomyelitis of maxilla bilateral involvement A case report. Journal of Indian Academy of Dental Specialists April-June 2011; 2[2]:57-8.
  8. Wong SK, Wilhelmus KR. Infantile maxillary osteomyelitis with cerebral abscess. Journal of Pediatric Ophthalmology and Strabismus. 1986; 23(3):153-54.
  9. Prasad K C, Prasad S C, Mouli N, Agarwal S. Osteomyelitis in the head and neck. ActaOtolaryngologica2007; 127:194-205.
  10. Edmonds M. The treatment of diabetic foot infections: focus on ertapenem. Journal of Vascular Health and Risk Management 2009; 5:949-63.

Corresponding Author

Dr Payal Nanwani
VSPM Dental College
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