Postoperative infection caused by Acinetobacter baumannii misdiagnosed as a free-living amoeba species in a humeral head
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CASE REPORT
Open Access
Postoperative infection caused by Acinetobacter baumannii misdiagnosed as a free-living amoeba species in a humeral head hemiarthroplasty patient: a case report Jiaxin Tang1†, Huaimin Zhu2†, Li Cai3, Tingting Tang1, Jian Tang1, Yuehua Sun1, Ming Liu1, Kerong Dai1, Zhiguang Qiao4,5* and Chao Yu1*
Abstract Background: Acinetobacter baumannii is ubiquitous, facultative intracellular, and opportunistic bacterial pathogen. Its unique abilities allow it to survive in a diverse range of environments, including health care settings, leading to nosocomial infections. And its exceptional ability to develop resistance to multiple antibiotics leaves few drug options for treatment. It has been recognized as a leading cause of nosocomial pneumonia and bacteremia over the world. Case presentation: In this case, a 73-year-old woman presented with a Neer Group VI proximal humeral fracture. Six hours after a successfully performed hemiarthroplasty, she developed continuous fever. Clinical examination revealed that the vitals were regular. Laboratory and radiographic examinations revealed only elevated procalcitonin levels. Blood culture revealed no bacterial or fungal growth. Cooling treatment and empirical broad-spectrum antibiotic therapy showed no apparent effect. Conclusions: We report a postoperative infection caused by Acinetobacter baumannii. The infectious pathogen was identified via molecular DNA sequencing and was initially misidentified as a free-living amoeba species upon microscopic examinations. The patient was mistreated with antiamebic combination therapy. Her symptoms persisted for over 4 months and were eventually followed by her death. Keywords: Acinetobacter baumannii, Free-living amoebae, Hemiarthroplasty, Case report
Multilingual abstracts Please see Additional file 1 for translations of the abstract into the five official working laguages of the United Nations. Background During the past few decades, Acinetobacter baumannii has received significant attention from scientific and * Correspondence: [email protected]; [email protected] † Equal contributors 4 Medical 3D Printing Innovation Research Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200125, China 1 Shanghai Key Laboratory of Orthopaedic Implants, Department of Orthopaedic Surgery, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China Full list of author information is available at the end of the article
medical communities [1–5]. Its unique abilities, such as intrinsically resistance to desiccation, allow it to survive in a diverse range of environments, including health care settings, leading to nosocomial infections and troublesome outbreaks [6]. As a nosocomial pathogen which is most commonly involved in hospital infections, A. baumannii has an exceptional ability to develop resistance to multiple antibiotics, leaving few drug options for treatment [3, 6–8]. Inappropriate initial antimicrobials were strongly associated with increased mortality for
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