Hafnia alvei: A new pathogen in open fractures

Area of Science:

• Orthopedic Surgery
• Infectious Diseases
• Microbiology

Background:

• Deep infection is a rare complication of open forearm fractures.
• Standard prophylactic antibiotics target common pathogens like Staphylococcus aureus and gram-negative bacteria.
• Hafnia alvei is an uncommon pathogen with limited reported human pathogenicity.

Observation:

• A 12-year-old male presented with a late deep infection following an open forearm fracture.
• Cultures from the infected site exclusively identified Hafnia alvei.
• The patient underwent surgical debridement and received antibiotic beads and ciprofloxacin treatment.

Findings:

• This case represents the first documented instance of deep infection secondary to Hafnia alvei in an open forearm fracture.
• The patient achieved a complete clinical recovery with no signs of infection at 6 months post-treatment.
• Full functional recovery of the affected forearm was observed without any lasting deficits.

Implications:

• Hafnia alvei should be considered in the differential diagnosis of unusual deep infections following open fractures.
• This case expands the known spectrum of pathogens involved in orthopedic post-traumatic infections.
• Further research may be warranted to understand the specific mechanisms of Hafnia alvei pathogenesis in orthopedic settings.