Surgical Site Infection by Corynebacterium macginleyi in a Patient with Neurofibromatosis Type 1.
Surgical Site Infection by Corynebacterium macginleyi in a Patient with Neurofibromatosis Type 1.
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DOI：
10.1155/2013/970678
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发表时间：
2013
影响因子：
1.1
通讯作者：
Nunnari G
中科院分区：
文献类型：
--
作者：
Cacopardo B;Stefani S;Cardì F;Cardì C;Pinzone MR;Nunnari G
棒状杆菌属（Corynebacterium）C. Macginleyi是一种革兰氏阳性亲脂性棒状杆菌，通常被认为是皮肤和粘膜表面的定殖者。有几个报告与C。macginleyi与眼部感染，如结膜炎和眼内炎。然而，即使是罕见的，来自C. macginleyi可能发生，尤其是在免疫功能低下的患者和留置医疗器械的患者中。我们在此报告第一例手术部位感染的C。1例1型神经纤维瘤病患者接受脊柱后凸矫形手术后的Macginleyi。我们的病人在C4-C5节段沿着手术疤痕出现了一个约沿着2厘米的结节性肉芽肿性病变，伴脓性分泌物和瘘管形成。颈部磁共振成像显示皮下组织中存在一个两厘米长的液体袋。从病灶边缘和渗出液中采集几个拭子，分离出C。macginleyi。该分离株对β-内酰胺类、复方新诺明、利奈唑胺和糖肽类药物敏感，但对喹诺酮类、第三代头孢菌素和红霉素耐药。两个30天疗程的抗生素治疗，阿莫西林/克拉维酸（1 g，每日三次）和复方新诺明（800/160 mg，每日两次），获得完全愈合的病变。
Corynebacterium (C.) macginleyi is a gram positive, lipophilic rod, usually considered a colonizer of skin and mucosal surfaces. Several reports have associated C. macginleyi with ocular infections, such as conjunctivitis and endophthalmitis. However, even if rare, extraocular infections from C. macginleyi may occur, especially among immunocompromised patients and patients with indwelling medical devices. We report herein the first case of surgical site infection by C. macginleyi after orthopaedic surgery for the correction of kyphoscoliosis in a patient with neurofibromatosis type 1. Our patient developed a nodular granulomatous lesion of about two centimetres along the surgical scar, at the level of C4-C5, with purulent discharge and formation of a fistulous tract. Cervical magnetic resonance imaging showed the presence of a two-centimetre fluid pocket in the subcutaneous tissue. Several swabs were collected from the borders of the lesion as well as from the exudate, with isolation of C. macginleyi. The isolate was susceptible to beta-lactams, cotrimoxazole, linezolid, and glycopeptides but resistant to quinolones, third-generation cephalosporins, and erythromycin. Two 30-day courses of antibiotic therapy with amoxicillin/clavulanate (1 g three times/day) and cotrimoxazole (800/160 mg twice a day) were administered, obtaining a complete healing of the lesion.