Title: Citrobacter Koseri osteomyelitis of maxilla- A Rarity
Authors: Dr Payal Nanwani, Dr Vrinda Kolte, Dr Ramakrishna Shenoi
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.