Faculty Collaboration Database

Microbiological tolerance in orthopaedic infections: delayed response of septic arthritis and osteomyelitis of the hip due to infection with tolerant Staphylococcus aureus. J Pediatr Orthop 1996;16(4):518-21

Date

07/01/1996

Pubmed ID

8784710

DOI

10.1097/00004694-199607000-00020

Scopus ID

2-s2.0-0029971822 (requires institutional sign-in at Scopus site)   9 Citations

Abstract

A 14-year-old boy presented to another hospital with a clinical picture of septic arthritis. After aspiration of purulent material from the joint, empiric antibiotic treatment was initiated and an arthrotomy was performed. Antibiotic treatment was then modified to nafcillin according to microbiological sensitivity results of the isolated Staphylococcus aureus as determined by minimal inhibitory concentration testing. One week later purulent drainage recurred and open drainage had to be repeated; an abscess anterior to the joint was noted. Once again the infection failed to resolve, and the patient was transferred to our institution where a third arthrotomy had to be performed. The organism isolated at the first aspiration was reexamined and found to have a minimal bactericidal concentration to minimal inhibitory concentration ratio of 32, implying a tolerant organism. The antibiotic treatment was modified to an antibiotic not subject to the tolerance phenomenon, and the infection resolved without additional surgical intervention.

Author List

Thometz JG, Lamdan R, Kehl KS, Chusid MJ

Author

John G. Thometz MD Professor in the Orthopaedic Surgery department at Medical College of Wisconsin

MESH terms used to index this publication - Major topics in bold

Adolescent
Arthritis, Infectious
Drug Tolerance
Humans
Male
Microbial Sensitivity Tests
Nafcillin
Osteomyelitis
Penicillins
Staphylococcal Infections
Staphylococcus aureus