CASE STUDY : Chromobacterium violaceum Osteomyelitis : A Rare Gram Negative Bacilli Infection.

Introduction  Chromobacterium violaceum is a gram-negative, motile, oxidase-positive bacillus and facultatively anaerobic. It is widely distributed in natural aquatic environments.   

Case summary A 24 years old Indian gentleman without comorbid alleged MVA (motor vehicle accident) on 2nd  November 2020. He sustained right sided orbital blow out fracture, maxillary sinus fracture with subluxation of orbital globe into right maxillary sinus, and traumatic optic neuropathy. He underwent multiple operation in between 10th  November 2020 to 22nd  January 2021. CT  brain and orbital done on 16th January 2021 showed pus discharge from forehead wound and temporal scalp swelling, skull osteomyelitis with left lid abscess. Pus aspirate from left scalp collected on 14th January and bone culture on 17th January 2021 both grew Chromobacterium violaceum.  Patient completed intravenous (IV) Unasyn 3g QID for 5 days followed by Tazocin for 2days. Repeated culture on 19th January 2021 from same side of left scalp wound was no growth.    

Discussion There are limited papers published in regards to Chromobacterium violaceum osteomyelitis and its association with hospital acquired infection. In this case, patient required multiple operation and long hospitalization but 2 months after admission, pus and bone culture grew Chromobacterium violaceum. American Journal of Infectious Control reported C violaceum isolated from water samples collected under sterile precautions from operation theatre. The contaminated water could be the source of infection and isolates from the hospital environment can be a source of nosocomial infection.

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