Culture of Vibrio extorquens from severe, chronic skin ulcers in a Puerto Rican woman

The Family Methylobacteriaceae

“…Methylobacterium strains have been increasingly reported as infectious agents in humans (Borsali et al 2011;Holton et al 1990;Lambert et al 1983;Sanders et al 2000;Truant et al 1998), with 30 clinical cases reviewed by Sanders et al (2000). Clinically recovered Methylobacterium strains are typically regarded as opportunistic pathogens in immunocompromised patients, such as those on chemotherapy (Engler and Norton 2001;Sanders et al 2000), and with immunosuppression due to alcoholism, renal failure, diabetes, tuberculosis, or (uncommonly) from patients with no previous underlying clinical condition (Gilardi and Faur 1984;Lai et al 2011;Lambert et al 1983;Liu et al 1997;Strazzi et al 1992;Truant et al 1998). Symptoms due to Methylobacterium infections range from bacteremia, fever, sepsis, empyema, pneumonia, peritonitis, to eye or urinary tract infection (Borsali et al 2011;Brown et al 1996;Fernandez et al 1997;Furuhata et al 2006;Hiraishi et al 1995;Lee et al 2004;Sanders et al 2000).…”

“…Examples are the fortuitous recovery of Mtb fujisawaense after long incubation of mycobacterial blood cultures (Fanci et al 2010), infections attributed to Pseudomonas mesophilica (Gilardi and Faur 1984;Rutherford et al 1988), Protomonas extorquens (Hayashi et al 1990;Holton et al 1990), and Vibrio extorquens (Lambert et al 1983).…”

“…The third and fourth postulates have not been tested in humans or to our knowledge in any animal model (''The cultured microorganism should cause disease when introduced into a healthy organism'' and ''the microorganism must be re-isolated from the inoculated, diseased experimental host and identified as being identical to the original specific causative agent''), although observed resurgence of the infection (and organism) in patients partly supports those criteria. Probably a convincing early example of Mtb extorquens as a primary pathogen was the chronic progressive skin nodulation and ulceration seen in a previously healthy individual, 15 years after hysterectomy and radiation therapy, in which the patient developed a high agglutination titer to the organism (Lambert et al 1983). This infection was completely resolved after 18 months treatment with a regime of ethambutol, isoniazid, rifampin, and kanamycin, and did not recur.…”

Pink-pigmented Non-fermentative Gram-negative Rods Associated with Human Infections: a Clinical and Diagnostic Challenge

“…Chronic cutaneous infections in healthy persons ranging from subcutaneous nodules of the finger to extensive ulcerative lesions of the buttocks have been described [2,24]. In addition to recovery of methylobacteria from biopsy tissue, serum from one individual had a 1:80 agglutinating antibody titer against the infecting agent [2].…”

“…In fact, these pink-pigmented bacteria although not biochemically characterized in enough detail to firmly establish a definitive identification most likely belonged to the genus Methylobacterium. The first unequivocal case of infection was reported almost two decades later in 1983 when Lambert et al [2] published a case report of an infected ulcer of the buttocks involving chronic granulomatous inflammation that yielded a Methylobacterium ("Vibrio extorquens") in pure culture.…”