Escherichia hermannii: A Rare Pathogen in Implant-Associated Infection Following a Type III C Open Distal Radius...

Escherichia hermannii is an infrequent monomicrobial pathogen in human infections. Notably, it has never been documented as the sole isolate in cases of infected radial shaft fractures.

This report presents a case of a non-union in a distal third radius shaft fracture associated with an E. hermannii-infected implant that remained in situ. The patient, who suffered a crush injury 3 months prior, initially underwent open reduction and internal fixation using a fibula strut graft secured with a titanium plate, along with primary wound closure. However, after 12 weeks, he developed an infection at the implant site, accompanied by a sinus tract. To address this complication, a repeat debridement was performed, and a retention strategy was implemented, allowing the original implant to be preserved.

The patient was treated with intravenous meropenem for 7 days, followed by an 11-week course of oral ciprofloxacin. At the conclusion of treatment, he remained free of infection, asymptomatic, and was able to continue working with excellent functional outcomes.