Campylobacter fetus bacteremia and meningitis in an acute lymphoblastic leukemia patient undergoing maintenance therapy: a case report

Abstract

Background Campylobacter fetus is an uncommon Campylobacter species, and its infections mainly cause infective endocarditis, aortic aneurysm, and meningitis rather than enteritis. It is more likely to be detected in blood than Campylobacter jejuni or Campylobacter coli, specifically reported in 53% of patients. In our case, C. fetus was detected in both blood and cerebrospinal fluid (CSF) cultures. Case presentation A 33-year-old woman, who was on maintenance chemotherapy for acute lymphoblastic leukemia (ALL), presented to our clinic with chief complaints of severe headache and nausea. Blood and CSF cultures revealed C. fetus. We administrated meropenem 2 g intravenously (IV) every 8 h for 3 weeks, and she was discharged without neurological sequelae. Conclusion We encountered a case of C. fetus meningitis without gastrointestinal symptoms, neck stiffness or jolt accentuation in a patient with ALL. Undercooked beef was considered the source of C. fetus infection in this case, suggesting that the need for a neutropenic diet and safe food handling be considered.

Campylobacter jejuni and other emerging Campylobacteraceae in retail beef liver – an underestimated potential source?

“…Consistent with previous reports (Narvaez -Bravo et al 2017;Tang et al 2017;Hormeño et 2020), all tetracycline-resistant C. jejuni isolates carried the tet(O) gene, which encodes a ribosomal protection protein. This gene is the major molecular determinant in tetracycline-resistant Campylobacter (Shen et al 2018).…”

“…Despite the fact that C. jejuni and C. coli are known to cause most cases of intestinal campylobacteriosis, other species such as C. fetus have been reported as a common cause of extraintestinal infection, mainly bacteraemia and meningitis (Costa and Iraola 2019; Nakatani et al . 2021). In this study, 7·8% of the samples tested positive for C. fetus , which was identified by phylogenetic analysis of the cpn60 gene (data not shown) (GenBank accession No.…”

Antimicrobial resistance in Campylobacter fetus: emergence and genomic evolution

“…Multiple studies on antimicrobial resistance of C. fetus describe the MIC of isolates [53,54], but since no susceptibility criteria are available for C. fetus, different cut-off values or breakpoints determined for other bacterial species have been used to determine if an isolate is resistant or susceptible, e.g. CLSI guidelines for Enterobacteriaceae [55] and CLSI guidelines for bacteria that grow aerobically [56,57].…”

Phenotypic and genetic analyses of two Campylobacter fetus isolates from a patient with relapsed prosthetic valve endocarditis

“…We also show conservation among ST3 Cff strains, pointing to a stable lineage with CITCf01 and CITCf02 belonging to this ST. Limited source attribution of sporadic cases exists, but food animals are often suspected (Costa et al 2020), despite the infrequent isolation of Cff from food (Scanlon et al 2013;Wagenaar et al 2014), where the latter may be a consequence of insufficient detection systems. Undercooked meat was implicated as the likely cause of C. fetus bacteraemia and meningitis in a 33-year-old woman on maintenance therapy for acute lymphoblastic leukaemia, suggesting that neutropenic diet should be considered (Nakatani et al 2021). As an alternative view to that of Nakatani et al (2021), C. fetus can establish as a member of the intestinal microbiota of healthy individuals (Iraola et al 2017), with the human gut serving as a natural reservoir.…”

“…Undercooked meat was implicated as the likely cause of C. fetus bacteraemia and meningitis in a 33-year-old woman on maintenance therapy for acute lymphoblastic leukaemia, suggesting that neutropenic diet should be considered (Nakatani et al 2021). As an alternative view to that of Nakatani et al (2021), C. fetus can establish as a member of the intestinal microbiota of healthy individuals (Iraola et al 2017), with the human gut serving as a natural reservoir. It is difficult to make this assumption about this case, as stool samples were not taken on the patient when CITCf01 and CITCf02 were isolated and Campylobacter spp.…”