Author:
Uçkay Ilker,Garbino Jorge,Dietrich Pierre-Yves,Ninet Béatrice,Rohner Peter,Jacomo Véronique
Abstract
Abstract
Background
Helicobacter cinaedi is a rare pathogen in humans, occurring mostly in immuno-compromised patients, with a high potential for recurrence. We describe a case of a patient with lymphoma hospitalized for chemotherapy.
Case presentation
At admission, the patient presented with an indolent and non-prurigenic macular rash around her implantable venous access device. Gram staining of blood cultures revealed the presence of spiral-shaped gram-negative rods that could not be grown upon subculture. Helicobacter cinaedi was identified by PCR. No other symptoms or pathology were observed in a whole body CT scan. The implantable venous access device was removed and empiric therapy by ceftriaxone and gentamicin for 2 weeks was initiated, followed by peroral clarithromycin 2 × 500 mg/day and later by levofloxacin 2 × 500 mg/day for 7 weeks. Oncologic remission was achieved 3 months later. However, the patient was re-hospitalized 2 months later for fever, shivering, reappearance of the macular non-prurigenic rash, diarrhea, cough and asthenia. Blood cultures grew H. cinaedi. Multiple investigations could not identify the source. Empiric antibiotic therapy of ceftriaxone and doxycycline was started for 2 weeks with resolution of symptoms, followed by an oral combination of amoxicillin, metronidazole and doxycycline for 2 months; doxycycline was continued for another month. Bacteremia has not recurred for a period of 19 months.
Conclusion
Although H. cinaedi is considered to be a low virulent bacteria, its potential to cause recurrent bacteremia should not be underestimated. H. cinaedi could have an endovascular source of infection and should be treated for an adequate duration with combined antibiotherapy.
Publisher
Springer Science and Business Media LLC
Reference30 articles.
1. De Groote D, Ducatelle R, Haesebrouck F: Helicobacters of possible zoonotic origin: a review. Acta Gastroenterol Belg. 2000, 63: 380-7.
2. Zenner L: Pathology, diagnosis and epidemiology of the rodent Helicobacter infection. Comp Immunol Microbiol Infect Dis. 1999, 22: 41-61. 10.1016/S0147-9571(98)00018-6.
3. Fox JG: The expanding genus of Helicobacter: pathogenic and zoonotic potential. Semin Gastrointest Dis. 1997, 8: 124-41.
4. Fox JG, Handt L, Sheppard BJ, Xu S, Dewhirst FE, Motzel S, Klein H: Isolation of Helicobacter cinaedi from the colon, liver, and mesenteric lymph node of a rhesus monkey with chronic colitis and hepatitis. J Clin Microbiol. 2001, 39: 1580-5. 10.1128/JCM.39.4.1580-1585.2001.
5. Maurer KJ, Ihrig MM, Rogers AB, Ng V, Bouchard G, Leonard MR, Carey MC, Fox JG: Identification of cholelithogenic enterohepatic helicobacter species and their role in murine cholesterol gallstone formation. Gastroenterology. 2005, 128: 1023-33. 10.1053/j.gastro.2005.01.008.
Cited by
52 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献