A case of Ignatzschineria bacteraemia in an unconscious man from the Netherlands

Heddema, Edou R.; Janssen, F. G. J.; Westreenen, Harro van

doi:10.1099/jmmcr.0.005043

Cited by 21 publications

(36 citation statements)

References 11 publications

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“…Combined microbiological and entomological research is needed to determine Ignatzschineria's pathogenicity and geographic distribution. Antibiotic treatment with beta-lactam antibiotics showed favorable results in our case as well as the cases reported in the literature [2][3][4][6][7][8].…”

Section: Discussionsupporting

confidence: 76%

“…Myiasis-maggot infestation of a live body-is most commonly found in domestic sheep, but rarely seen in humans with chronic wounds. Recent case reports described an association between maggot infestation and bloodstream infections in humans by gram-negative rod bacteria, which could later be identified as Ignatzschineria species by 16S rRNA gene amplification and sequencing after matrix assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) was unsuccessful [1][2][3][4][5][6][7] (excluding one case [8]). The Ignatzschineria genus is composed of three species (I. indica, I. larvae, and I. ureiclastica) living as a gut-associated bacteria in larvae and adult forms of flesh flies, of which mostly Wohlfahrtia magnifica was described as vector for the pathogen [9].…”

Section: Introductionmentioning

confidence: 99%

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Sepsis Due to Ignatzschineria ureiclastica Caused by Maggot-Infested Wounds in a Homeless Man in Germany: a Case Report

Tanida

Wichert

Hentschke³

et al. 2019

SN Compr. Clin. Med.

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The gram-negative rod bacteria Ignatzschineria inhabits the digestive tract of larvae and adult forms of flesh flies and mostly causes bloodstream infections in animals, but rarely in humans with chronic wounds. This is the second case report of sepsis due to Ignatzschineria ureiclastica worldwide and the first reported case of Ignatzschineria species in Germany. We present a case report of 57-year-old homeless male with chronic leg and foot ulcers with maggot infestation. Blood cultures revealed gramnegative rod bacteria, which later could be identified by 16S rRNA sequence analysis as Ignatzschineria ureiclastica. Intravenous antibiotic treatment with ampicillin/sulbactam and later oral ciprofloxacin as well as local wound management lead to complete wound healing. Blood cultures of patients with chronic wounds and maggot infestation should be analyzed with 16S rRNA sequence analysis when commercial-automated devices lead to indecisive results. Live and preserved samples of insect infestation should be acquired for further entomological characterization. Susceptibility testing of rare pathogens should be performed and published. Antibiotic treatment of bloodstream infections due to Ignatzschineria species with ampicillin/sulbactam showed good clinical outcome.

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Section: Discussionsupporting

confidence: 76%

Section: Introductionmentioning

confidence: 99%

Sepsis Due to Ignatzschineria ureiclastica Caused by Maggot-Infested Wounds in a Homeless Man in Germany: a Case Report

Tanida

Wichert

Hentschke³

et al. 2019

SN Compr. Clin. Med.

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show abstract

“…In a similar case reported in 2016, a man with a history of alcohol and nicotine abuse and COPD was admitted after being found unconscious and hypoxemic in front of his house. Results showed an elevated white blood cell count, C-reactive protein, and serum glucose [ 6 ]. Physical examination revealed a wound between his first and second toe on his right foot in which a great number of maggots were present.…”

Section: Literature Reviewmentioning

confidence: 99%

A Case of Ignatzschineria indica Bacteremia following Maggot Colonization

Muse

Jenkins

Oliver

et al. 2017

Case Reports in Infectious Diseases

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Ignatzschineria indica is a Gram-negative bacterium that is commonly associated with the larvae of flesh flies. I. indica is difficult to isolate in routine laboratory procedures but has been associated with neglected wounds infested with maggots, fever, elevated white blood count and C-reactive protein, and polymicrobial culture results. Other specific hematological/immunological changes are not known. We present a case of I. indica bacteremia and polymicrobial osteomyelitis resulting from infected decubitus ulcers. The patient improved after treatment with cefepime followed by levofloxacin.

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“…Ignatzschineria spp. along with Providencia stuartii was isolated from the patient and in high abundance from the salivery gland of Lucilia serricata (blowfly) [3,4]. Baker et al reported for the first time human cases of bacteremia and urinary tract infection from where I. indica was isolated, associated with maggots [5].…”

Section: Discussionmentioning

confidence: 99%

“…It was found during analysis that the patient had never removed socks and shoes for 2 months, and the wound was contaminated with maggots, the larvae of flies. A Ignatzschineria bacteremia was recently reported from Netherlands [3]. Ignatzschineria spp.…”

Section: Discussionmentioning

confidence: 99%

Ignatzschineria indica Isolated From a Human Breast Abscess: A Rare Case

et al. 2016

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Ignatzschineria indica is a gram-negative aerobic bacillus, usually isolated from the gut content of adult flesh flies or larvae of Wohlfahrtia magnifica. Ignatzschineria spp. associated with human infection is hypothesized to be related to maggot therapy. We are reporting the first case of Ignatzschineria indica isolated from a breast abscess, along with Proteus penneri and Providencia stuartii in a 76-year-old female. The patient presented with a left breast mass, weight loss, and normal vital signs; physical examination of the left breast showed a fungating mass with foul smelling draining necrotic tissue and a left axillary abscess. A biopsy was performed that revealed an invasive mammary carcinoma (mucinous type) with the tumor ulcerating the overlying skin. Additionally, a culture of the abscess yielded growth of gram-negative rods. The organism was identified as I. indica by 16S rRNA gene sequencing. Although the pathogenic capacity of the organism cannot be determined at this point, we are establishing the need for further study of patients with cultures positive for I. indica in order to understand the pathologic implications, and therapy to control this organism in human host.

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A case of Ignatzschineria bacteraemia in an unconscious man from the Netherlands

Cited by 21 publications

References 11 publications

Sepsis Due to Ignatzschineria ureiclastica Caused by Maggot-Infested Wounds in a Homeless Man in Germany: a Case Report

Sepsis Due to Ignatzschineria ureiclastica Caused by Maggot-Infested Wounds in a Homeless Man in Germany: a Case Report

A Case of Ignatzschineria indica Bacteremia following Maggot Colonization

Ignatzschineria indica Isolated From a Human Breast Abscess: A Rare Case

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