Tibial osteitis caused by Pantoea agglomerans after open grade IIIB tibial shaft fracture

Bone infection is not an uncommon complication of open tibial shaft fractures. We report an unusual case of chronic tibial osteitis caused by Pantoea agglomerans after an open grade IIIB tibial shaft fracture. P. agglomerans, an enterobacteria, was identified on bone samples obtained nine months after the fracture. The infection probably resulted from the initial soil contamination and developed despite fixation and bone covering with a muscle flap performed during the same operative time and adapted intravenous antibiotics.