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