Cellulitis and Sepsis Due to Sphingobacterium

Marinella, Mark A.

doi:10.1001/jama.288.16.1985-a

Cited by 33 publications

(32 citation statements)

References 3 publications

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“…A second Sphingobacterium species, S. multivorum, has been isolated more frequently from clinical specimens but has only rarely been associated with serious infections (1,3,8,10,15). Interestingly, most recently a respiratory infection caused by S. multivorum was reported (16), indicating a possible clinical role of sphingobacteria in the respiratory tract.…”

Section: Case Reportmentioning

confidence: 99%

Extrinsic Allergic Alveolitis (Hypersensitivity Pneumonitis) Caused by Sphingobacterium spiritivorum from the Water Reservoir of a Steam Iron

Kämpfer

Engelhart²,

Rolke³

et al. 2005

J Clin Microbiol

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A case of extrinsic allergic alveolitis (EAA) caused by Sphingobacterium spiritivorum is described. The symptoms were associated with the use of a steam iron. The water reservoir was heavily contaminated with S. spiritivorum (10 6 CFU ml ؊1 ). This is the first report of S. spiritivorum as a causative agent of EAA. CASE REPORTA 34-year-old woman presented with a dry cough, thorax constriction, and overall weakness. During the preceding 5 months, she had experienced these dry cough episodes twice a week. On examination, the patient was febrile (39°C), but a clinical lung examination showed no striking diagnostic findings. The high-resolution computer tomography-Roentgen image was normal; however, a lung function test showed a restriction of the vital capacity (71% of the adjusted reference value), and the diffusion capacity was also reduced (66 to 68%).During a hospital stay of several days' duration, the patient was free of discomfort. In the bronchoalveolar lavage specimen, the lymphocytes were increased up to 41% (norm, Ͻ10%), and neutrophils were increased up to 6% (norm, Ͻ2%) with a normal total cell count. This bronchoalveolar lavage specimen cell pattern indicated an acute phase of extrinsic allergic alveolitis (EAA; hypersensitivity pneumonitis). The erythrocyte sedimentation rate was increased up to 20/35 mm. The patient's conventional chest X ray and high-resolution computer tomography images were free of any alterations, based on criteria outlined previously (11).The patient's detailed history revealed that she had used an iron before each of the episodes of discomfort. She had used a steam iron which is additionally equipped with a liquid reservoir for wetting of the clothes.Using the agar gel diffusion test (Ouchterlony assay described previously [13]), the water of this liquid reservoir showed a clear precipitation line with the serum of the patient, indicating the presence of precipitating immunoglobulin G (IgG) antibodies in the serum of the patient against antigens in the water.No IgG antibodies could be detected against a wide panel of organisms which are commonly associated with EAA, including Saccharopolyspora rectivirgula, Thermoactinomyces vulgaris, Aspergillus fumigatus (also not in an IgG immunoblot),

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Section: Case Reportmentioning

confidence: 99%

Extrinsic Allergic Alveolitis (Hypersensitivity Pneumonitis) Caused by Sphingobacterium spiritivorum from the Water Reservoir of a Steam Iron

Kämpfer

Engelhart²,

Rolke³

et al. 2005

J Clin Microbiol

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“…13 Cases of nonnecrotizing soft tissue infection due to other Sphingobacterium species have also been reported. 8,14 In the present case, the patient was relatively immunocompromised by long duration of septicemia and non-healing wounds at many sites on the skin, and S. multivorum is a well-known risk factor for skin and soft tissue infection. 12 Here in this case source of the pathogen could not be established but it is speculated that it was either environmental or commensal on patient's skin.…”

Section: Discussionmentioning

confidence: 74%

Sphingobacterium multivorum causing fatal meningoencephalitis: a rare case report

et al. 2014

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“…It has been implicated in septicemia in immunocompromised patients (3,6,8) and respiratory tract infections in patients with cystic fibrosis (5). Of note, two cases of nonnecrotizing soft tissue infection due to other Sphingobacterium species have been reported (7,11). In the present case, the patient was relatively immunocompromised by long-term steroid treatment (12) and by diabetes mellitus, a well-known risk factor for skin and soft tissue infection (1).…”

mentioning

confidence: 67%

Necrotizing Fasciitis and Septic Shock Related to the Uncommon Gram-Negative Pathogen Sphingobacterium multivorum

et al. 2012

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We report the first case of necrotizing fasciitis due to the uncommon Gram-negative pathogen Sphingobacterium multivorum in an immunocompromised patient, who presented with septic shock. This case adds necrotizing fasciitis to the spectrum of S. multivorum-related infections and highlights the emergence of Gram-negative bacteria in severe soft tissue infections. CASE REPORTA 64-year-old woman was referred to our intensive care unit (ICU) for septic shock. Her medical history included rheumatoid arthritis that had been treated with long-term intermediate-dose corticosteroids (0.25 mg/kg of prednisone per day for more than 30 years), morbid obesity (body-mass index, 33.5 kg/m 2 ), type 2 diabetes mellitus, and coronary disease. Her current treatment included 15 mg prednisone per day, rosuvastatine, metformine, atenolol, perindopril, aspirin, and furosemide. Twenty-four hours after her dog scratched her right leg, she developed fever and leg pain. She presented at the emergency department 48 h after the injury; her central body temperature was 38.2°C, heart rate was 100 beats/min, blood pressure was 82/43 mmHg, and respiratory rate was 35/min. She was confused. Her skin was mottled from legs to abdominal wall. Her right leg was erythematous and tender to palpation with swelling. The rest of the examination was uninformative. Biological results were as follows: C-reactive protein, 583 mg/liter (normal value [N], Ͻ6 mg/ liter); leukocyte count, 12.2 ϫ 10 9 /liter; arterial lactate level, 7.9 mmol/liter (N, Ͻ2 mmol/liter); HCO 3 Ϫ level, 13.4 mmol/liter; creatininemia, 320 mol/liter; and creatinine phosphokinase level, 874 IU/liter (N, Ͻ200 IU/liter). She was transferred to our ICU, where broad-spectrum antibiotic therapy, consisting of amoxicillin-clavulanate, clindamycin, and gentamicin, was initiated along with fluid loading. The blood pressure remained low, and the patient became comatose. She required circulatory support with norepinephrine up to 2.9 g/kg/min, mechanical ventilation, and low-dose steroids. Her condition deteriorated in the first 48 h to multiple organ failure with acute anuric renal failure requiring renal replacement therapy and disseminated intravascular coagulation (platelet count was 41 ϫ 10 9 /liter and prothrombin rate was 51%, whereas initial values were normal). At the same time, the patient exhibited soft tissue necrosis of the right leg, prompting extensive surgical debridement. Surgical findings revealed a typical aspect of necrotizing fasciitis (NF), with gray necrotic tissues and lack of bleeding, that was subsequently confirmed by histological examination.Three blood cultures from samples taken before antibiotic treatment and surgery remained sterile. Gram-stained surgical samples (fascia and subcutaneous tissues) displayed polymorphic Gramnegative bacilli. Bacterial cultures of all five samples revealed yellowpigmented colonies of a single aerobic oxidase-positive Gramnegative bacillus (Fig. 1), growing after 18 h at 37°C on blood and chocolate agars but not Drigalski medium, which...

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Cellulitis and Sepsis Due to Sphingobacterium

Cited by 33 publications

References 3 publications

Extrinsic Allergic Alveolitis (Hypersensitivity Pneumonitis) Caused by Sphingobacterium spiritivorum from the Water Reservoir of a Steam Iron

Extrinsic Allergic Alveolitis (Hypersensitivity Pneumonitis) Caused by Sphingobacterium spiritivorum from the Water Reservoir of a Steam Iron

Sphingobacterium multivorum causing fatal meningoencephalitis: a rare case report

Necrotizing Fasciitis and Septic Shock Related to the Uncommon Gram-Negative Pathogen Sphingobacterium multivorum

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