We present five cases of Solobacterium moorei bacteremia. The isolates were identified with 16S rRNA gene sequencing and were susceptible to common antibiotics used for anaerobic infections. Bacteremia with S. moorei seems to be associated with debilitating conditions, but the prognosis of the infection appears to be good. CASE REPORTS Case 1.A 43-year-old man with a previous medical record of lymphoma and a kidney transplantation 11 years earlier was admitted to the department of nephrology. He had a fever, anemia, diarrhea, and general malaise and was complaining about a toothache. His temperature was 38.9°C. The total leukocyte count was 11.7 ϫ 10 9 cells/liter (reference count is 3.0 ϫ 10 9 to 10.0 ϫ 10 9 cells/liter), and the C-reactive protein was 82 mg/liter (reference is Յ10 mg/liter). Two sets of blood cultures were performed. After 3 days of incubation in the Bactec 9240 blood culture system (Becton Dickinson Diagnostic Instrument Systems, Franklin Lakes, NJ), both anaerobic blood culture bottles were positive for a short, Gram-positive bacillus later identified as Solobacterium moorei with the use of 16S rRNA gene sequencing. Antibiotic treatment with intravenous benzylpenicillin and oral metronidazole was initiated. The same day, a dental examination was done and a tooth extraction was performed because of abscess formation. The patient's fever and symptoms responded to treatment. Six days after admission, the patient demanded himself discharged. Oral phenoxymethylpenicillin and metronidazole were continued for another week, and 13 days after admission the C-reactive protein had decreased to Ͻ10 mg/liter. Case 2. A 66-year-old woman with a known non-small-cell lung carcinoma was admitted to the department of oncology because of fever and fatigue. Her temperature was 39.1°C. The total leukocyte count was 7.2 ϫ 10 9 cells/liter, and the C-reactive protein was 208 mg/liter. Two sets of blood cultures were performed, and antibiotic treatment with intravenous cefuroxime and gentamicin was initiated. Three days later, both anaerobic blood culture bottles were positive for S. moorei. A chest X ray revealed progression of a previously known rightsided nodule. Magnetic resonance imaging of the brain showed meningeal carcinomatosis but no signs of cerebral infection. The fever and cerebral symptoms disappeared, and 1 week after admission the antibiotic treatment was stopped because the patient developed a rash. At this time, the C-reactive protein had decreased to 12 mg/liter. Two weeks later, her fever relapsed and she became septic with low blood pressure. Treatment with meropenem and metronidazole was initiated, and 2 days later Eikenella corrodens was isolated from her blood cultures. A chest X ray revealed a pulmonary abscess for which she was treated with oral ciprofloxacin and metronidazole for 3 weeks.Case 3. A 64-year-old man with a previous medical record of colon cancer and complicated abdominal surgery 3 years earlier was admitted to the department of abdominal surgery. He had a fever and signs of ...

Background The duration of viable Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) shedding in immunocompromised patients is still unknown. This case report describes the duration of viable SARS-CoV-2 in two immunocompromised patients with completely different clinical courses and further addresses the immunological aspects. Case presentations Oropharyngeal swaps were collected continuously during hospitalization for two immunocompromised patients infected with SARS-CoV-2 and sent for analysis to real time reverse transcription polymerase chain reaction (RT-PCR), viral culture assessed by plaque assay and full genome sequencing. Blood samples for flow cytometry and further immunological analysis were taken once during admission. One patient was without symptoms of Coronavirus disease 2019 (COVID-19) whereas the other had severe respiratory symptoms requiring a stay at an intensive care unit (ICU) and treatment with remdesivir and dexamethasone. Despite their difference in clinical courses, they both continuously shed SARS-CoV-2 with high viral loads in culture. Both patients had undetectable anti SARS-CoV-2 IgG levels about 2 weeks after the first positive real time RT-PCR test of SARS-CoV-2, marked expansions of virus reactive CD8+ T cells but cellular markers indicative of attenuated humoral immunity. Conclusions Our case illustrates the importance of distinguishing isolation guidelines for patients infected with SARS-CoV-2 according to their immunological status. Furthermore, it demonstrates the need for immune markers relating to viral shedding in immunocompromised patients.

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