Case report: pulmonary nocardiosis caused by Nocardia exalbida in an immunocompetent patient

Abstract Background Nocardiosis is known as an opportunistic infection in immunocompromised hosts, but it occasionally has been reported in immunocompetent patient. The Nocardia exalbida is first-reported in 2006 from Japan, and a few cases of have been reported in only immunocompromised host, and the characteristic is still unclear. We herein describe the first case of pulmonary nocardiosis caused by N. exalbida in an immunocompetent patient. Case presentation A77 -year-old Japanese man was admitted to our hospital on November 2, 2018. He was a lifelong non-smoker with no childhood history of respiratory disease. He had a medical history of dyslipidemia. One month before this admission fevers, sputum, mild cough were developed and he was evaluated in a clinic near our hospital. His diagnosis was community acquired pneumonia within his right middle lobe. He was treated with ceftriaxone 1 g/day intravenously for a week, however his symptoms relapsed a few days later. So, the physician retried ceftriaxone for another 3 days, but his symptoms did not improve. He was referred to our hospital. He was treated with sitafloxacin as an outpatient for a week, however his symptoms got worse. The chest CT showed consolidation and atelectasis in his right middle lobe. Low density area was scattered in consolidation, and right pleural effusion was observed. The patient was diagnosed with pulmonary abscess and he was admitted. Administration of piperacillin/tazobactam improved his condition. We switched antibiotics to amoxicillin/clavulanate, and he was discharged. After 2 weeks, he relapsed and was admitted again. After administration of piperacillin/tazobactam for 3 weeks, we perform bronchoscopy and Nocardia species were cultured from samples of the bronchial wash. The isolates were identified as N. exalbida using 16S rRNA gene sequencing. We prescribed Trimethoprim / Sulfamethoxazole (TMP/SMX) for 4 months. Then we switched to minocycline for renal dysfunction caused from TMP-SMX for 1 more month. After 5 months therapy, Consolidation on CT disappeared, and Nocardiosis was cured. Conclusion we reported the first case of pulmonary nocardiosis caused by N. exalbida in an immunocompetent patient. N. exalbida infection might be associated with a good response to treatment.

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“Flexispira rappini” Bacteremia in a Child with Pneumonia

Journal of Clinical Microbiology ◽

10.1128/jcm.36.6.1679-1682.1998 ◽

1998 ◽

Vol 36 (6) ◽

pp. 1679-1682 ◽

Cited By ~ 29

Author(s):

Wee Tee ◽

Karin Leder ◽

Elena Karroum ◽

Michael Dyall-Smith

Keyword(s):

16S Rrna Gene Sequencing ◽

Middle Lobe ◽

Base Substitution ◽

Rrna Gene ◽

Invasive Infection ◽

Biochemical Tests ◽

History Of ◽

Chest X Ray ◽

Right Middle Lobe ◽

Rrna Gene Sequencing

We describe a case of “Flexispira rappini” bacteremia from a 9-year-old girl who presented with a 5-day history of fever, productive cough, and malaise. A chest X-ray result was compatible with right middle lobe pneumonia. Blood culture grew a gram-negative spiral fusiform bacterium 2 days after the inoculation. Biochemical tests showed the organism to be catalase negative, oxidase positive, sodium hippurate hydrolysis negative, and urea hydrolysis negative. 16S rRNA gene sequencing identified this organism as “F. rappini,” showing a six-base substitution from the type strain. This is the first report of “F. rappini” bacteremia in a human, suggesting that this organism has the potential of causing invasive infection, but its role in pneumonia is uncertain and could be unrelated to the bacteremia.

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Campylobacter insulaenigrae bacteremia with meningitis: a case report

BMC Infectious Diseases ◽

10.1186/s12879-021-06353-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Moe Kyotani ◽

Tsuneaki Kenzaka ◽

Hozuka Akita ◽

Soichi Arakawa

Keyword(s):

Blood Culture ◽

Marine Mammals ◽

Chronic Subdural Hematoma ◽

16S Rrna Gene Sequencing ◽

Enhancement Effect ◽

Rrna Gene ◽

Clinical Report ◽

Bacterial Strains ◽

Fisher Syndrome ◽

First Case

Abstract Background The bacterium Campylobacter insulaenigrae was first isolated from marine mammals of Scotland in 2004. Only one case of C. insulaenigrae infection in humans has been previously reported. Case presentation An 89-year-old Japanese man without dementia was admitted to our hospital, because he presented with a fever of 38 °C and weakness in right leg since 5 days. He had organized chronic subdural hematoma (CSH), and no history of pre-infection. At the time of admission, he had paralysis of the extraocular muscle, ataxia, and low manual muscle test score of the right side. He was suspected to have Miller Fisher syndrome; however, these symptoms improved without any treatment. On day 22 in the hospital, the patient presented a fever of 38.8 °C, left cranial nerve disorder, and hemiplegia. On day 25, the patient presented with signs of meningeal irritation; cerebrospinal fluid examination indicated an increase in the number of apocytes and a low glucose level. A contrast magnetic resonance imaging (MRI) scan of the patient’s head indicated a contrast enhancement effect in his right meninges. The blood culture showed presence of spirillums; 16S rRNA gene sequencing confirmed that the spirillums in the blood culture were Campylobacter insulaenigrae (C. insulaenigrae). We started treatment with meropenem for bacteremia and meningitis. When the symptoms improved, meropenem was replaced with ampicillin, based on the result of the drug sensitivity test. The treatment continued for 4 weeks. Conclusions We report the first case of meningitis caused by C. insulaenigrae bacteremia in humans, and the second clinical report of C. insulaenigrae infection in humans. The bacterial strains isolated from humans and marine mammals had different genotypes. This suggests that different genotypes could be responsible for differences in the hosts. Further case studies are needed to establish the reasons behind the difference in the manifestations of C. insulaenigrae infections reported so far.

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First case of an invasive Bacteroides dorei infection detected in a patient with a mycotic aortic aneurysm—raising a rebellion of major indigenous bacteria in humans: a case report and review

BMC Infectious Diseases ◽

10.1186/s12879-021-06345-8 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Takayuki Matsuoka ◽

Takuya Shimizu ◽

Tadanori Minagawa ◽

Wakiko Hiranuma ◽

Miki Takeda ◽

...

Keyword(s):

Aortic Aneurysm ◽

16S Rrna ◽

16S Rrna Gene ◽

Gene Sequencing ◽

16S Rrna Gene Sequencing ◽

Resected Specimen ◽

Rrna Gene ◽

Sequencing Analysis ◽

First Case ◽

Rrna Gene Sequencing

Abstract Background Bacteroides dorei is an anaerobic gram-negative bacterium first described in 2006. Because of the high similarity in mass spectra between B. dorei and Bacteroides vulgatus, discriminating between these species is arduous in clinical practice. In recent decades, 16S rRNA gene sequencing has been a complementary method for distinguishing taxonomically close bacteria, including B. dorei and B. vulgatus, at the genus and species levels. Consequently, B. dorei has been shown to contribute to some diseases, including type 1 autoimmune diabetes mellitus and atherosclerotic diseases. However, there are no reports on invasive infectious diseases caused by B. dorei. This report describes the first case of direct invasion and colonisation of human tissue by B. dorei, thus providing a warning regarding the previously proposed application of B. dorei as a live biotherapeutic for atherosclerotic diseases. Case presentation A 78-year-old Japanese man complained of intermittent chest/back pain and was diagnosed with a mycotic thoracic aortic aneurysm by enhanced computed tomography on admission. Despite strict blood pressure control and empirical antibiotic therapy, the patient’s condition worsened. To prevent aneurysmal rupture and eliminate infectious foci, the patient underwent surgical treatment. The resected specimen was subjected to tissue culture and 16S rRNA gene sequencing analysis to identify pathogenic bacteria. A few days after the surgery, culture and sequencing results revealed that the pathogen was B. dorei/B. vulgatus and B. dorei, respectively. The patient was successfully treated with appropriate antibacterial therapy and after improvement, was transferred to another hospital for rehabilitation on postoperative day 34. There was no recurrence of infection or aneurysm after the patient transfer. Conclusions This report describes the first case of invasive infectious disease caused by B. dorei, casting a shadow over its utilisation as a probiotic for atherosclerotic diseases.

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Molecular Identification and Epidemiological Tracing of Pasteurella multocida Meningitis in a Baby

Journal of Clinical Microbiology ◽

10.1128/jcm.38.3.1235-1237.2000 ◽

2000 ◽

Vol 38 (3) ◽

pp. 1235-1237 ◽

Cited By ~ 34

Author(s):

Patrick Boerlin ◽

Hans H. Siegrist ◽

André P. Burnens ◽

Peter Kuhnert ◽

Purita Mendez ◽

...

Keyword(s):

Pasteurella Multocida ◽

Close Contact ◽

Gene Sequencing ◽

16S Rrna Gene Sequencing ◽

Rrna Gene ◽

Source Of Infection ◽

Subspecies Level ◽

History Of ◽

Rrna Gene Sequencing ◽

The One

We report a case of Pasteurella multocida meningitis in a 1-month-old baby exposed to close contact with two dogs and a cat but without any known history of injury by these animals. 16S rRNA gene sequencing of the isolate from the baby allowed identification at the subspecies level and pointed to the cat as a possible source of infection. Molecular typing of Pasteurella isolates from the animals, from the baby, and from unrelated animals clearly confirmed that the cat harbored the same P. multocidasubsp. septica strain on its tonsils as the one isolated from the cerebrospinal fluid of the baby. This case stresses the necessity of informing susceptible hosts at risk of contracting zoonotic agents about some basic hygiene rules when keeping pets. In addition, this study illustrates the usefulness of molecular methods for identification and epidemiological tracing ofPasteurella isolates.

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A Possible Association of Diindolylmethane with Pulmonary Embolism and Deep Venous Thrombosis

Case Reports in Medicine ◽

10.1155/2016/7527098 ◽

2016 ◽

Vol 2016 ◽

pp. 1-4 ◽

Cited By ~ 1

Author(s):

Peter V. Bui ◽

Maan Moualla ◽

Dona J. Upson

Keyword(s):

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Lower Extremity ◽

Venous Thrombosis ◽

Deep Venous Thrombosis ◽

Single Case ◽

The United States ◽

Middle Lobe ◽

History Of ◽

Right Middle Lobe

Introduction.3,3′-Diindolylmethane is available as a supplement in the United States for “cancer prevention” and “augmentation of physical fitness.” A derivative of indole-3-carbinol found in plants, diindolylmethane, binds to receptors associated with the sex steroid pathways and has unclear effects on estrogen and androgen physiology. We present a patient who had been taking diindolylmethane and developed right lower extremity deep venous thrombosis and bilateral pulmonary embolism.Case Presentation.A 65-year-old man presented with swelling, erythema, and warmth of his right lower extremity for three to four weeks. He had been taking diindolylmethane one tablet daily for three to four months. Risk factors for venous thromboembolism included tobacco use, personal history of possible pulmonary embolism, body mass index, and age. Imaging studies found extensive deep venous thrombosis in his right lower extremity and bilateral pulmonary embolism with probable right middle lobe infarction. Follow-up imaging showed chronic deep venous thrombosis in his right lower extremity.Discussion.As suggested in this single case, patients who take diindolylmethane may be at greater risk for venous thromboembolism. Further reports and studies are necessary in order to elucidate this possible association. Clinicians should question patients about supplements in the setting of venous thromboembolism.

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Longitudinal Characterization of the Tumoral Microbiome during Radiotherapy in HPV-associated Oropharynx Cancer

10.1101/2020.06.08.20124974 ◽

2020 ◽

Author(s):

Houda Bahig ◽

Clifton D Fuller ◽

Aparna Mitra ◽

Travis Solley ◽

Sweet Ping Ng ◽

...

Keyword(s):

Alpha Diversity ◽

16S Rrna Gene Sequencing ◽

Concurrent Chemotherapy ◽

Rrna Gene ◽

Entire Cohort ◽

Oropharynx Cancer ◽

History Of ◽

Rrna Gene Sequencing ◽

Never Smokers

ABSTRACTPurposeTo describe the baseline and serial tumor microbiome in HPV-associated oropharynx cancer (OPC) over the course of radiotherapy (RT).MethodsPatients with newly diagnosed HPV-associated OPC treated with definitive radiotherapy +/- concurrent chemotherapy were enrolled in this prospective study. Using 16S rRNA gene sequencing, dynamic changes in tumor microbiome during RT were investigated. Surface tumor samples were obtained before RT and at week 1, 3 and 5 of RT. Radiological primary tumor response at mid-treatment was categorized as complete (CR) or partial (PR).ResultsTen patients were enrolled. Mean age was 63 years (range: 51-71). As per AJCC 8th Ed, 50%, 20% and 30% of patients had stage I, II and III, respectively. At 4-weeks, 7 patients had CR and 3 patients had PR; at follow-up imaging post treatment, all patients had CR. Baseline diversity of tumoral and buccal microbiomes was not statistically different. For the entire cohort, alpha diversity was significantly decreased over the course of treatment (p=0.02). There was a significant alteration in the bacterial community within the first week of radiation. Baseline tumor alpha diversity of patients with CR was significantly higher than those with PR (p=0.03). While patients with CR had significant reduction in diversity over the course of radiation (p=0.02), the diversity remained unchanged in patients with PR. Patients with history of smoking had significantly increased abundance of Granulicatella (p=0.04), and Kingella (0.05) and lower abundance of Alloprevotella (p=0.04) compared to never smokers.ConclusionsThe tumor microbiome of HPV-associated OPC exhibits reduced alpha diversity and altered taxa abundance over the course of radiotherapy. The baseline bacterial profiles of smokers vs. non-smokers were inherently different. Baseline tumor alpha diversity of patients with CR was higher than patients with PR, suggesting that the microbiome as a biomarker of radiation response deserves further investigation.

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Empyema necessitatis due to Citrobacter freundii: Case report

Revista de la Facultad de Medicina ◽

10.15446/revfacmed.v66n4.67069 ◽

2018 ◽

Vol 66 (4) ◽

pp. 639-642

Author(s):

Diego Andrés Rodríguez-Lugo

Keyword(s):

Computed Tomography ◽

Cognitive Deficit ◽

Middle Lobe ◽

Citrobacter Freundii ◽

X Ray ◽

First Case ◽

Antibiotic Management ◽

History Of ◽

Chest X Ray ◽

Positive Report

Introduction: This paper presents the first case of empyema necessitatis secondary to infection with Citrobacter freundii (according to the databases consulted), and one of the few reports of this pathology in Colombia.Case presentation: This is the case of a 26-year-old patient from a rural area, with a history of severe cognitive deficit, who was taken to the emergency department due to a clinical picture of 15 days of evolution consisting of neurological deterioration associated with asthenia, adynamia, fever and cough with purulent expectoration. On admission, a chest x-ray was taken, finding pneumonia of the middle lobe with associated pleural effusion, for which empirical antibiotic management was initiated. The patient presented clinical deterioration and appearance of right pectoral mass, so a computed tomography of the thorax was performed, revealing empyema necessitatis. Close drainage and culture of the collection were made, with negative mycobacteria culture and positive report for C. freundii. The patient received specific antibiotic treatment for 8 weeks, with complete improvement of his clinical condition.Conclusion: Besides being the first case of empyema necessitatis by C. freundii that has been reported, this case is important because of the low amount of reports on this pathology in Colombia, considering that its main cause is tuberculosis, which is endemic in the country.

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Analysis of Vaginal and Endometrial Microbiota Communities in Infertile Women With a History of Repeated Implantation Failure

10.21203/rs.3.rs-73125/v1 ◽

2020 ◽

Author(s):

Takuhiko Ichiyama ◽

Keiji Kuroda ◽

Yoko Nagai ◽

Daichi Urushiyama ◽

Motoharu Ono ◽

...

Keyword(s):

16S Rrna Gene Sequencing ◽

Rrna Gene ◽

Implantation Failure ◽

Repeated Implantation Failure ◽

Infertile Women ◽

Healthy Women ◽

History Of ◽

Rrna Gene Sequencing ◽

Clinical Trials Registry

Abstract Background: Repeated implantation failure (RIF) is estimated to occur in 15%–20% of infertile women undergoing in vitro fertilization-embryo transfer (IVF-ET). Molecular identification recently confirmed that the uterine microbiota may have implications for reproductive and obstetrical outcomes. One hundred forty-five women who had been diagnosed with RIF were enrolled in the study. Twenty-one healthy women were also enrolled as controls. We investigated their vaginal and endometrial microbiotas using 16S rRNA gene sequencing and compared the microbiota profiles in the patients with RIF and controls.Results: The endometrial microbiotas had higher α-diversities than did the vaginal microbiotas (p<0.001 in both patients with RIF and healthy women). The microbiota profiles showed that vaginal and endometrial samples in patients with RIF had significantly higher levels of 5 and 14 bacterial genera, respectively, than those in healthy women. These genera included Atopobium, Gardnerella, Prevotella and Megasphaera. Vaginal Lactobacillus rates in patients with RIF were significantly lower at 76.4 ± 38.9% compared with those of the controls at 91.8 ± 22.7% (p=0.018), but endometrial Lactobacillus rates did not significantly differ between the RIF patients and controls (56.2 ± 36.4% and 58.8 ± 37.0%, respectively, p=0.79) Conclusions: Impaired microbiota communities containing specific bacteria in both the endometrium and vagina were associated with implantation failure. The Lactobacillus rate in the vagina, but not the endometrium, may be a biomarker for RIF.Trial registration: UMIN Clinical Trials Registry, UMIN000031731, Registered 15 March 2018; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000036121

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Septic arthritis due to Roseomonas gilardii in an immunocompetent adolescent

Journal of Medical Microbiology ◽

10.1099/jmm.0.011106-0 ◽

2009 ◽

Vol 58 (11) ◽

pp. 1514-1516 ◽

Cited By ~ 14

Author(s):

Sergio Fanella ◽

Daryl Schantz ◽

James Karlowsky ◽

Ethan Rubinstein

Keyword(s):

Septic Arthritis ◽

Gene Sequencing ◽

16S Rrna Gene Sequencing ◽

Sports Injury ◽

Bordetella Bronchiseptica ◽

Rrna Gene ◽

First Case ◽

Vitek 2 ◽

Rrna Gene Sequencing ◽

Slow Growing

The genus Roseomonas comprises groups of slow-growing, Gram-negative coccobacilli, which only infrequently cause infection in humans. When identified, they are associated with immunocompromised adults, often causing bacteraemia. Due to their rarity, members of this genus can be overlooked or misidentified using automated laboratory identification systems. We report on an immunocompetent adolescent patient who developed septic arthritis due to Roseomonas gilardii following surgery for a sports injury. The isolate was initially misidentified as Bordetella bronchiseptica using the Vitek 2 system, but confirmed as R. gilardii based on 16S rRNA gene sequencing. To the best of our knowledge, this is the first case of a healthy paediatric patient with septic arthritis due to R. gilardii.

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Postoperative spondylodiscitis due to Kytococcus schroeteri in a diabetic woman

Journal of Medical Microbiology ◽

10.1099/jmm.0.010454-0 ◽

2010 ◽

Vol 59 (1) ◽

pp. 127-129 ◽

Cited By ~ 8

Author(s):

H. Jacquier ◽

A. Allard ◽

P. Richette ◽

H. K. Ea ◽

M. J. Sanson-Le Pors ◽

...

Keyword(s):

Prosthetic Valve Endocarditis ◽

16S Rrna Gene Sequencing ◽

Diabetic Woman ◽

Rrna Gene ◽

Postoperative Spondylodiscitis ◽

Osteoarticular Infections ◽

First Case ◽

Skin Flora ◽

Rrna Gene Sequencing ◽

Kytococcus Schroeteri

Kytococcus schroeteri, a Gram-positive coccus, is usually regarded as part of the human skin flora. It has been described in prosthetic valve endocarditis but never as being involved in osteoarticular infections. We report here the first case of a spondylodiscitis due to K. schroeteri identified by 16S rRNA gene sequencing.

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