Fatal Wound Infection Caused by Chromobacterium violaceum in Ho Chi Minh City, Vietnam

Abstract

Chromobacterium violaceum is a proteobacterium found in soil and water in tropical regions which rarely causes infection in humans. Here, we report a fatal bacteremia caused by Chromobacterium violaceum in Vietnam. We describe a number of clinical, microbiological, and molecular aspects associated with this bacterial infection.

Chromobacterium violaceum: A Review of an Unexpected Scourge

“…As the disease progressed to sepsis, the leucocyte count gradually increased in parallel with decreasing haemoglobin and thrombocyte values. 98 Following the initial infection, hematogenic spread occurred, as shown by the high proportion of positive blood culture in these patients (Table 1). The hematogenic dissemination also caused multiple small pustules to occur in other areas of the body.…”

“…As the disease progressed to sepsis, the leucocyte count gradually increased in parallel with decreasing haemoglobin and thrombocyte values. 98

Figure 2 Picture of a patient with black purplish abscess in the right cheek extending to the right ear ( A ) and Chromobacterium violaceum shown on a culture plate ( B ). Notes: Reproduced from Darmawan G, Kusumawardhani RY, Alisjahbana B, Fadjari TH.

…”

Chromobacterium violaceum: A Review of an Unexpected Scourge

“…As the disease progressed to sepsis, the leucocyte count gradually increased in parallel with decreasing haemoglobin and thrombocyte values. 98 Following the initial infection, hematogenic spread occurred, as shown by the high proportion of positive blood culture in these patients (Table 1). The hematogenic dissemination also caused multiple small pustules to occur in other areas of the body.…”

“…As the disease progressed to sepsis, the leucocyte count gradually increased in parallel with decreasing haemoglobin and thrombocyte values. 98

Figure 2 Picture of a patient with black purplish abscess in the right cheek extending to the right ear ( A ) and Chromobacterium violaceum shown on a culture plate ( B ). Notes: Reproduced from Darmawan G, Kusumawardhani RY, Alisjahbana B, Fadjari TH.

…”

Fatal Chromobacterium violaceum bacteraemia in rural Bandundu, Democratic Republic of the Congo

“…In the present patient, and similarly to other observations [2,6] , the family denied unusual exposure to water, such as swimming or near-drowning. There were no skin lesions suspected of being contaminated by soil [1,3,4] . The patient initially presented with community-acquired sepsis of uncertain origin [2] , making the aetiological diagnosis almost impossible, as laboratory and imaging data were not available.…”

Clinical presentation and treatment of 2 patients with infection caused by Chromobacterium violaceum in Vietnam

“…In our opinion, although case 2 was treated in combination with cefepime, the antibiogram results in case 1 (limited antibiogram) showed that C. violaceum was resistant to ceftazidime. Third generation cephalosporins are known to not be effective for C. violaceum [2,4,5]. While case 1 was treated with a combination of two antibiotics effective for C. violaceum according to the antibiogram, the treatment was initiated late (day 16 of the disease), allowing the disease to progress further.…”

Chromobacterium violaceum: A Review of an Unexpected Scourge

“…As the disease progressed to sepsis, the leucocyte count gradually increased in parallel with decreasing haemoglobin and thrombocyte values. 98 Following the initial infection, hematogenic spread occurred, as shown by the high proportion of positive blood culture in these patients (Table 1). The hematogenic dissemination also caused multiple small pustules to occur in other areas of the body.…”

“…As the disease progressed to sepsis, the leucocyte count gradually increased in parallel with decreasing haemoglobin and thrombocyte values. 98

Figure 2 Picture of a patient with black purplish abscess in the right cheek extending to the right ear ( A ) and Chromobacterium violaceum shown on a culture plate ( B ). Notes: Reproduced from Darmawan G, Kusumawardhani RY, Alisjahbana B, Fadjari TH.

…”

Fatal Chromobacterium violaceum bacteraemia in rural Bandundu, Democratic Republic of the Congo

“…In the present patient, and similarly to other observations [2,6] , the family denied unusual exposure to water, such as swimming or near-drowning. There were no skin lesions suspected of being contaminated by soil [1,3,4] . The patient initially presented with community-acquired sepsis of uncertain origin [2] , making the aetiological diagnosis almost impossible, as laboratory and imaging data were not available.…”

Clinical presentation and treatment of 2 patients with infection caused by Chromobacterium violaceum in Vietnam

“…In our opinion, although case 2 was treated in combination with cefepime, the antibiogram results in case 1 (limited antibiogram) showed that C. violaceum was resistant to ceftazidime. Third generation cephalosporins are known to not be effective for C. violaceum [2,4,5]. While case 1 was treated with a combination of two antibiotics effective for C. violaceum according to the antibiogram, the treatment was initiated late (day 16 of the disease), allowing the disease to progress further.…”

Chromobacterium violaceum: A Review of an Unexpected Scourge

“…As the disease progressed to sepsis, the leucocyte count gradually increased in parallel with decreasing haemoglobin and thrombocyte values. 98 Following the initial infection, hematogenic spread occurred, as shown by the high proportion of positive blood culture in these patients (Table 1). The hematogenic dissemination also caused multiple small pustules to occur in other areas of the body.…”

“…As the disease progressed to sepsis, the leucocyte count gradually increased in parallel with decreasing haemoglobin and thrombocyte values. 98

Figure 2 Picture of a patient with black purplish abscess in the right cheek extending to the right ear ( A ) and Chromobacterium violaceum shown on a culture plate ( B ). Notes: Reproduced from Darmawan G, Kusumawardhani RY, Alisjahbana B, Fadjari TH.

…”

Fatal Chromobacterium violaceum bacteraemia in rural Bandundu, Democratic Republic of the Congo

“…In the present patient, and similarly to other observations [2,6] , the family denied unusual exposure to water, such as swimming or near-drowning. There were no skin lesions suspected of being contaminated by soil [1,3,4] . The patient initially presented with community-acquired sepsis of uncertain origin [2] , making the aetiological diagnosis almost impossible, as laboratory and imaging data were not available.…”

Clinical presentation and treatment of 2 patients with infection caused by Chromobacterium violaceum in Vietnam

“…In our opinion, although case 2 was treated in combination with cefepime, the antibiogram results in case 1 (limited antibiogram) showed that C. violaceum was resistant to ceftazidime. Third generation cephalosporins are known to not be effective for C. violaceum [2,4,5]. While case 1 was treated with a combination of two antibiotics effective for C. violaceum according to the antibiogram, the treatment was initiated late (day 16 of the disease), allowing the disease to progress further.…”