DOI QR코드

DOI QR Code

Bacterial Osteomyelitis Induced by Morganella morganii in a Bearded Dragon (Pogona vitticeps)

  • Kwon, Jun (Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Kim, Sang Wha (Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Kim, Sang Guen (Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Kim, Hyoun Joong (Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Giri, Sib Sankar (Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University) ;
  • Park, Se Chang (Laboratory of Aquatic Biomedicine, College of Veterinary Medicine and Research Institute for Veterinary Science, Seoul National University)
  • Received : 2020.05.20
  • Accepted : 2020.12.07
  • Published : 2020.12.31

Abstract

Bacterial osteomyelitis-or bacterial infection of the bone-is common in reptiles. Unfortunately, its treatment is challenging despite advances in diagnostic and medical technologies. Herein, we present the case of a sexually mature female bearded dragon (Pogona vitticeps) with left forelimb elbow joint stiffness. We diagnosed the reptile with a eft elbow joint traumatic structural abnormality based on gross examination and evaluation of radiographs. Treatment with clindamycin and cephalexin for bacterial infection failed and the reptile died. Necropsy revealed the causative bacteria as Morganella morganii. Treatment of osteomyelitis is typically focused against Staphylococcus aureus as it the most common cause of traumatic bone infection. However, M. morganii, the causative bacterium in this case, has a natural resistance to clindamycin and cephalexin. Recently, these bacteria have begun to appear in clinical reports, more commonly as the causative organisms of bone infections. M. morganii should be considered as a potential cause of infection. Furthermore, antibiotic treatment in such cases should be based on bacterial culture and susceptibility tests.

Keywords

References

  1. Antinoff N. Osteomyelitis in reptiles. Proc ARAV. 1997: 149-152.
  2. Autmizguine J, Watt KM, Theoret Y, Kassir N, Laferriere C, Parent S, Tapiero B, Ovetchkine P. Pharmacokinetics and pharmacodynamics of oral cephalexin in children with osteoarticular infections. Pediatr Infect Dis J 2013; 32: 1340-1344. https://doi.org/10.1097/INF.0b013e3182a222a6
  3. De A, Raj HJ, Maiti PK. Biofilm in osteomyelitis caused by a rare pathogen, Morganella morganii: A case report. J Clin Diagn Res 2016; 10: DD06.
  4. Dipineto L, Russo TP, Calabria M, De Rosa L, Capasso M, Menna LF, Borrelli L, Fioretti A. Oral flora of Python regius kept as pets. Lett Applied Microbiol 2014; 58: 462-465. https://doi.org/10.1111/lam.12214
  5. Frank AL, Marcinak JF, Mangat PD, Tjhio JT, Kelkar S, Schreckenberger PC, Quinn JP. Clindamycin treatment of methicillin-resistant Staphylococcus aureus infections in children. Pediatr Infect Dis J 2002; 21: 530-534. https://doi.org/10.1097/00006454-200206000-00010
  6. Isaza R, Jacobson ER. Antimicrobial drug use in reptiles. In: Antimicrobial Therapy in Veterinary Medicine, 5th ed. New Jersey: Wiley-Blackwell. 2013; 623-636.
  7. James SB, Calle PP, Raphael BL, Papich M, Breheny J, Cook RA. Comparison of injectable versus oral enrofloxacin pharmacokinetics in red-eared slider thirties, Trachemys scripta elegans. J Herpetol Med Surg 2013; 13: 5-10.
  8. Lazzarini L, De Lalla F, Mader JT. Long bone osteomyelitis. Curr Infect Dis Rep 2002; 4: 439-445. https://doi.org/10.1007/s11908-002-0012-4
  9. Lew DP, Waldvogel FA. Osteomyelitis. Lancet 2004; 364: 369-379. https://doi.org/10.1016/S0140-6736(04)16727-5
  10. Liu H, Zhu J, Hu Q, Rao X. Morganella morganii, a non-negligent opportunistic pathogen. Int J Infect Dis 2016; 50: 10-17. https://doi.org/10.1016/j.ijid.2016.07.006
  11. O'Hara CM, Brenner FW, Miller JM. Classification, identification and clinical significance of Proteus, Providencia and Morganella. Clin Microbiol Rev 2000; 13: 534-546. https://doi.org/10.1128/CMR.13.4.534-546.2000
  12. Stead AC. Osteomyelitis in the dog and cat. J Small Ani Pract 1984; 25: 1-13. https://doi.org/10.1111/j.1748-5827.1984.tb00474.x
  13. Stock I, Wiedemann B. Identification and natural antibiotic susceptibility of Morganella morganii. Diagn Micr Infect Dis 1998; 30: 153-165. https://doi.org/10.1016/S0732-8893(97)00243-5
  14. Stock I. Natural antibiotic susceptibility of Proteus spp., with special reference to P. mirabilis and P. penneri strains. J Chemotherapy 2003; 15: 12-26. https://doi.org/10.1179/joc.2003.15.1.12
  15. Zaninetti M, Baglivo E, Safran AB. Morganella morganii endophthalmitis after vitrectomy: case report and review of the literature. Klin Monbl Augenheilkd 2003; 220: 207-209. https://doi.org/10.1055/s-2003-38176
  16. Zhao C, Tang N, Wu Y, Zhang Y, Wu Z, Li W, Qin X, Zhao J, Zhang G. First reported fatal Morganella morganii infections in chickens. Vet Microbiol 2012; 156: 452-455. https://doi.org/10.1016/j.vetmic.2011.11.021