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Table 2 Summary of E. cloacae osteoarthritis in patients without post-traumatic or post-operative medical history

From: Enterobacter cloacae infection of the shoulder in a 52-year-old woman without apparent predisposing risk factor: a case report and literature review

No. Gender Age (years old) The site(s) of osteoarthritis Comorbidities Chief complaints/Symptoms Sample of microbiological test Pathogen (s) Antibiotic treatment Inflammatory markers on admission The isolated or cultured E. cloacae sensitive antibiotics Outcome
1 (our case) F 52 Right shoulder Had right and left surgical kidney stone removal in 7 and 15 years ago. Rotator cuff tear. 6-year history of right shoulder pain and restricted movement, worsened in the last month. Fever, sore throat. Burning sensation, swelling and redness around the right shoulder Joint aspiration E. Cloacae Levofloxacin (300 mg, IV, q12h, 5 days) → 0.5 g, po, qd, 11 days → 300 mg, IV, q12h, 9 days → 0.5 g, po, qd, 17 days WBC:12.7 × 109/L, CRP:41.2 mg/dL, ESR:65 mm/h Details in Table 1 Recovery
2 [12] M 2 Left knee Osteoarticular infection at the same site 2 years earlier (no organism was identified), and he was born via forcep delivery Limp and left knee pain and swelling for 2 weeks Joint aspiration and synovial tissue E. Cloacae Meropenem(20 mg/kg, IV, q8h, 3 weeks) → Sulfamethoxazole–Rimethoprim (4 mg/kg, q12h, po, 6 months) NA Meropenem, cefepime, ciprofloxacin and trimethoprim-sulphamethoxazole Recovery
3 [13] F 36 Right shoulder HIV-positive, sickle cell anemia, latent tuberculosis infection Fever, weight loss, fatigue, 4-months history of right shoulder pain Joint aspiration and surgical specimens E. Cloacae and Mycobacterium tuberculosis Imipenem and Amikacin for 2 weeks, IV CRP:0 Imipenema, latomoxef, amikacin, pefloxacin and ciprofloxacin Recovery
4 [14] M 14 Left sacroiliac joint Sepsis 1-day history of fever and hip pain aggravated by walking, ARDS happened on the third hospital day Blood E. Cloacae Vancomycin(4 g/day) and Ceftriaxone (4 g/day) → Ceftriaxone (4 g/day) and Amikacin (1.5 g/day) for 6 weeks WBC: 6.4 × 109/L, ESR:12 mm/h, CRP:3.1 mg/dL Amikacin, aztreonam, ceftriaxone, ceftazidime, cefotaxime, ciprofloxacin, gentamicin, imipenem, piperacillin/tazobactam; Recovery
5 [15] M 88 T10/T11 Long-term urinary catheter, malignancy Back pain, fever, rigors, weight loss Blood E. Cloacae Meropenum (IV, 3 weeks) and Ciprofloxacin (Long time) WBC: 10.06 × 109/L, CRP: 227 mg/dL NA Failed to therapy
6 [16] M 54 C3-C4 Meningitis and sepsis secondary to urinary tract infection after transrectal ultrasound and biopsies, he had a raised PSA level and acute renal failure 10-day history of headaches, dizziness, neck pain and altered sensation in his upper, limbs Blood E. Cloacae and Klebsiella oxytoca Ciprofloxacin and metronidazole for 5 days → Ceftriaxone (IV, 2 weeks) and a longer course of oral ciprofloxacin NA NA Recovery
7 [17] M 57 leg MSSA infection at the same site after an open fracture 31 years ago. After successful treatment, the facture healed and he remained asymptomatic until the present episode. The implant material was removed many years ago 1-week history of leg pain, swelling and local tenderness but no inflammation of the overlying skin or draining fistula Bone E. Cloacae Garamycin (3 weeks) and Cefepime (6 weeks) NA NA Recovery
8 [18] M 52 L5-S1 Had a extracorporeal shock wave lithotripsy due to right renal lithiasis and hydronephrosis Chills, shaking, high fever, back pain, restricted lumbar movements Blood and urine E. Cloacae Amikacin (1500 mg/day) Indometacin (150 mg/day) for 1 week → Ceftriaxone (2 g, q12h, 1 week) → 1 g/day,3 months) WBC:18 × 109/L, CRP:12.3 mg/dL ESR:110 mm/h Ceftriaxone and amikacin Recovery
9 [19] M 47 Multiple joints Acute pancreatitis, multi-organ failure, ARDS, systemic fatty necrosis High fever, chills, low tension, tachycardia, painful erythematous nodules on the arms, thighs, ankles and fingers Blood and joints aspiration E. Cloacae Pefloxacin, metronidazole and amoxicillin→imipenem-cilastatin WBC: 5.2 × 109/L, CRP:201 mg/dL NA Dead
10 [20] M 50 Cervical spine Hypertension, arthritis, and a gunshot wound to the left chest and birdshot to the head and neck 20 years earlier that resulted in a seizure disorder, and the pellet had not been removed 4-day history of neck pain spreading to right temporal region, right shoulder, right lateral chest, and right upper back from the scapula to the midthoracic spine, mild dysphagia Blood E. Cloacae NA WBC:7.9 × 109/L NA Recovery
11 [21] M 10 weeks old Left proximal tibia Watery stools, malnourished and dehydration 5 weeks earlier. Intraosseous (IO) needle had been placed into the proximal left tibia and a permanent Silastic intravenous catheter had been inserted to start parenteral nutrition and antibiotics Desquamating dermatitis, erythematous nodules on the back skin, the left lower extremity was erythematous and indurated Blood, bone and the serosanguinous aspiration expressed by the IO needle Candida albicans and E. cloacae Ampicillin and cefotaxime(IV) → Ticarcilin-clavulanate(IV) → Fluconazole and aztreonam → amphotericin B and aztreonam NA NA Recovery
12 [22] M 28 L4-L5 HIV-positive, intravenous heroin abused, hepatitis C 2-month history of severe low back pain, fever, night sweats, and weight loss. The lumbar spine was markedly tender with bilateral paravertebral muscle spasm Joint aspiration E. Cloacae Amikacin (1 g/day, intramuscular, 3 weeks) and pefloxacin (800 mg/day, IV, 3 weeks) → pefloxacin ((800 mg/day, po, 14 weeks) WBC:9.2 × 109/L, ESR:50 mm/h Amikacin, pefloxacin, and trimethoprim-sulphamethoxazole Recovery
13 [23] F 68 T8-T9 Gallstones with repeated hepatic colic for 3 years. Intravenous urography, and a barium enema had been done 2-week history of severe pain in the right hypochondrium that increased with motion, general malaise, anorexia, and dystermia. Fever after barium enema Blood and Joint aspiration E. Cloacae trimethoprim(160 mg, q12h, IV, 10 days) and sulphamethoxazole (800 mg, q12h, IV, 10 days) → (trimethoprim-sulphamethoxazole, po) WBC:5.9 × 109/L, ESR:127 mm/h Gentamicin and trimethoprim-sulphamethoxazole Recovery
14 [24] F Prematre neonate (28 weeks) Multiple joints Premature, hyaline membrane disease, sepsis. Umbilical artery catheter was inserted, continuous positive airway pressure using nasal prongs, intravenous nutrition Septic shock, cyanosis, tachypnea, grunting, erythematous left ankle, knee effusion, lost passive and active motion in hips Blood, joints aspiration (Hips, right knee, right ankle) and tip of the catheter E. cloacae (blood, joints aspiration and tip of the catheter) Klebsiella pneumonia (blood) Gentamicin (2 mg, q8h, IV, 6 days) and Methicillin (IV, 6 days) → Furadantin (2.5 mg, q6h, IV, 9 days) → Furadantin (2.5 mg, q6h, IV) and Nalidixic acid NA Furadantin and Nalidixic acid Recovery
  1. MSSA Methicillin-sensitive S. aureus, PSA Prostate-specific antigen, WBC White blood cell, CRP C-reactive protein, ESR Erythrocyte sedimentation rate, → From the former treatment changed to the latter, NA Not available