Escherichia hermanniias the sole cause of osteomyelitis in a patient with an open tibial shaft fracture

Abstract

Escherichia hermanniiis a rare monomicrobial cause of infection in humans.E. hermanniihas never before been reported as the sole isolate from an infected open tibia fracture. We present a case ofE. hermanniiinfection after a type III open tibia fracture. The patient was initially treated with irrigation and debridement, open reduction internal fixation and primary wound closure. However, after 8 weeks, he developed a draining wound and infection at the fracture site. He required a repeat debridement, hardware removal, external fixation and 6 weeks of intravenous ceftriaxone for treatment. At 2-year follow-up, he remains infection free, asymptomatic and continues to work with excellent functional outcomes. This case adds to the growing literature that evidencesE. hermanniias an organism that can be pathogenic, virulent and cause monomicrobial infection.