Cases study of Chromobacterium violaceum Infection among Patients at Department of Female Orthopaedic, Mahasarakham Hospital

Abstract

Background : On August 23, 2017 has reported from Department of Female Orthopaedic by ICWN has a patient one case pus culture positive for C.violaceum infection. Patient has right arm pain, abnormal swollen, wound injury about 1 centimeter before came to hospital about 6 hours. Then we have investigation with ICWN, Head of Department of Female Orthopaedic, Medical technician and Doctor between August 23-30, 2017.

Objectives : To confirm diagnosis, epidemiology of diseases by time place and persons, risk of  infection, source of epidemiology, and to prevention and control of diseases.

Methods : Report was descriptive study to explore the epidemiology of C. violaceum. All data were collected from medical records, interview doctor, ICWN, head of Department of Female Orthopaedic, medical technician, ICWN of Srinagarind Hospital and laboratory test results.

Results : Female patient was 67 years. She is a farmer came to hospital with right arm injury, pain and abnormal swollen. Refer from district hospital and first diagnosis for open fracture both bone of right forearm. At the beginning patients got Cefazolin and DB with ORIF with Small DCP operation. Of 2-8 days patient have fever and right arm have bump and swollen then have wound care and change antibiotics.  Patients have pus culture positive for C.violaceum infection. Patients refer to Srinagarind Hospital, have fever and pus culture negative for bacteria. Patients receive Clindamycin and Ceftriazone to treatment but still have high fever and change to Sulperazone then patients getting better. After discharge 2 days patients have pus in wound and high fever came back to Srinagarind Hospital again. Patients have wound care and pus culture negative. On August 23, 2017 patients have plate & screw removal and on external fixation and change to Cefazolin and Gentamicin. Patients getting better then change to Augmentin 1X2 oral for 10 days and discharge and continue to treatment at hospital near home.

Results and recommendation : Patient has confirmed diagnosis for C.violaceum Although these  infection, non respond for treatment especially who have history about soil or contaminate water The appropriated antibiotics used can reduce the severity of diseases.  

Keyword : Chromobacterium violaceum,