A first fatal case of acute myeloid leukemia combined with Laribacter hongkongensis bacteremia: a case report and literature review

Abstract

Abstract Background: Laribacter hongkongensiswas initially isolated from the blood and pleural fluid samples of a patient with alcoholic liver cirrhosis in Hong Kong in 2001. Despite the low isolation rate in the population at present, the mortality rate of bacteremia caused by this pathogen has reached as high as 50%. To date, no documented cases have reported the co-occurrence of acute myeloid leukemia (AML) and L. hongkongensisbacteremia. Case Presentation: A male patient with liver cirrhosis from southern China came for a medical consultation in the Department of Hematology due to a 10-dayfever. The immunohistochemical (IHC) and Bone marrow aspiration (BMA) examination results indicated AML, which showed improvement following one year of induction and consolidation chemotherapy. However, after the completion of the second cycle of induction chemotherapy, the patient presented with a recurring fever, reaching a body temperature of 40°C. Blood culture results suggested Gram-negative bacilli and subsequent identification using MALDI-TOF MS and 16S rRNA gene sequencing confirmed the presence of Laribacter hongkongensis. Unfortunately, the complex pathogenicity and resistance mechanisms remain unidentified, leading to fatal outcomes in our patients despite receiving meropenem treatment, which was chosen based on antimicrobial susceptibility testing (AST) results. Conclusions: We reported the first fatal case of AML combined with L. hongkongensis bacteremia based on liver disease. Hepatic dysfunction and the consumption of freshwater fish and frogs are commonly recognized as high-risk factors for infection. Therefore, strengthening preventive measures, early identification, and the appropriate utilization of antibiotics have emerged as crucial strategies for preventing and improving infections.