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

Abstract

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),

Genome of the pathogen Porphyromonas gingivalis recovered from a biofilm in a hospital sink using a high-throughput single-cell genomics platform

“…Sequencing 16S rRNA genes PCR-amplified from 416 single-cell MDA reactions, we found 18 candidate commensal and potentially pathogenic species that were selected for 454 shallow sequencing. Initial read mapping and de novo assembly of the low-coverage 454 sequence data confirmed that we had obtained genomic sequences for the pathogen Streptococcus pneumoniae as well as bacterial species highly similar to and those reported to be potentially pathogenic, including Sphingobacterium spiritivorum (Tronel et al 2003;Kampfer et al 2005), Leptotrichia buccalis (Hammann et al 1993;Hot et al 2008), as well as the host-associated oral bacteria, Streptococcus mitis and Veillonella parvula. Of particular note, we found three MDA products with sequences for the oral pathogen Porphyromonas gingivalis, which is a periodontal pathogen involved in periodontal bone loss that has also been linked to progression of atherosclerotic disease (Pussinen et al 2007;Yilmaz 2008).…”

Sphingobacterium spiritivorumsepticaemia associated with cellulitis in a patient with Parkinson's disease

“…The most common clinical isolates of S. spiritivorum have been from blood, urine and respiratory secretions 4 5 . S. spiritivorum has been associated with causing respiratory tract infections in patients with cystic fibrosis,5 cellulitis and sepsis,6 bacteraemia7 and hypersensitivity pneumonitis (extrinsic allergic alveolitis) 8. Most reported patients have had an immunocompromised state or multiple medical comorbidities 9…”

The First Korean Case ofSphingobacterium spiritivorumBacteremia in a Patient with Acute Myeloid Leukemia

“…To date, 7 cases of S. multivorum infection have been reported worldwide in relation to septicemia [5, 18-20], peritonitis [21], respiratory tract infection [22], and necrotizing fasciitis [23]. Only 3 cases of S. spiritivorum infection have been reported worldwide [24-26]. The present case and previously reported cases are compared in Table 2.…”

“…In 2003, Tronel et al [25] reported a case of S. spiritivorum bacteremia. In 2005, Kronel et al [26] reported a case of cellulitis-associated sepsis caused by S. spiritivorum from the water reservoir of a steam iron.…”