Late-onset sepsis and encephalopathy after bicycle-spoke injury: a case report

BMC Infect Dis. 2019 May 28;19(1):472. doi: 10.1186/s12879-019-4082-4.

Abstract

Background: Bicycle-spoke injuries rarely cause late complications of infection, including sepsis and sepsis-associated encephalopathy, with appropriate treatments.

Case presentation: We experienced a 2-year-old girl who developed the signs of encephalopathy with fever 6 months after a spoke-injury. On admission, the injured skin was inflamed with cellulitis. The blood culture was positive for methicillin-sensitive Staphylococcus aureus. Electroencephalogram showed diffuse slow-wave activity. Diffusion-weighted magnetic resonance imaging detected a high-intensity lesion with decreased diffusivity at the right frontal cortex. She received immunoglobulin and combined antibiotics treatments in the intensive care unit, and successfully overcame the sepsis-associated encephalopathy without neurological impairments.

Conclusion: This is the first report demonstrating that sepsis and its associated encephalopathy occurs in a remote period after the bicycle-spoke injury.

Keywords: And Staphylococcus aureus; Ankle injury; Cellulitis; Pathogens; Sepsis-associated encephalopathy.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / drug therapy
  • Bacteremia / etiology*
  • Bicycling / injuries*
  • Brain Diseases / diagnostic imaging
  • Brain Diseases / etiology*
  • Child, Preschool
  • Electroencephalography
  • Female
  • Fever / drug therapy
  • Humans
  • Magnetic Resonance Imaging
  • Staphylococcal Infections / drug therapy
  • Staphylococcal Infections / etiology*
  • Wounds, Penetrating / etiology

Substances

  • Anti-Bacterial Agents