<i>Oerskovia xanthineolytica</i> endocarditis in a renal transplant patient: case report and review of the literature

Urbina, Benjamin; Gohh, Reginald; Fischer, Staci A.

doi:10.1111/j.1399-3062.2003.00034.x

Cited by 23 publications

(13 citation statements)

References 18 publications

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“…Prosthetic joint infection and pyogenic flexor tenosynovitis, both foreignbody-associated infections, have also been reported (13,16), but a case of septic arthritis due this microorganisms has never been described. In most of the cases already reported involving C. cellulans (14 of 21 cases), infection was secondary to a medical device, and removal of the device was required for resolution of the infection in the majority of them (4, 7, 9, 10, 14, 16,18,19,21). In the other two cases, infection was related to an invasive procedure, such as cholangio-pancreatic endoscopy and steroid injections (16).…”

Section: Case Reportmentioning

confidence: 99%

Septic Arthritis Due to Cellulosimicrobium cellulans

et al. 2011

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Cellulosimicrobium cellulans has been reported as a rare cause of human pathogenesis. Infections mainly occur in immunocompromised patients and very often are associated with a foreign body. We report the first case of septic arthritis caused by C. cellulans in an immunocompetent patient. Our patient suffered a penetrating palm tree thorn injury to his left knee 8 weeks before admission. Although no foreign objects were found, they were suspected because previous reports suggest a frequent association with this microorganism, and open debridament was performed. Removal of foreign bodies related to this organism must be considered a high-priority treatment in these patients to achieve a complete recovery. CASE REPORTAn 81-year-old man was admitted to our department with a 6-day history of pain, loss of motion, erythema, and swelling in his left knee. His past medical history was significant for gout, mild mitral regurgitation, hypertension, and moderate chronic renal insufficiency, and 8 weeks previously he had been admitted to our department with septic arthritis of the same knee caused by Pantoea agglomerans after suffering a penetrating injury to his left knee with a palm tree thorn, with good response to treatment with intravenous ceftriaxone (1 g per day for 15 days) and levofloxacin (250 mg per day for 15 days).Physical examination showed an afebrile patient with a painful, warm, swollen, and tender left knee. Limitation of active and passive range of motion were also noted. Otherwise, the examination was unremarkable. Laboratory tests showed an elevated serum C-reactive protein (CRP) level (17 mg/dl; normal, Ͻ0.5) with a normal blood cell count. Arthrocentesis yielded 30 ml of yellowish fluid. Direct microscopic examination of the synovial fluid revealed many leukocytes, and crystal analysis with compensated polarized light was negative. Gram stain was negative, and empirical treatment with levofloxacin was started intravenously (500-mg initial dose and then 250 mg every 24 h, with creatinine clearance of 40 ml/min because of renal failure,). Three days after admission, a Gram-positive rod grew in synovial cultures and was subsequently identified as Cellulosimicrobium cellulans. Identification was initially made by matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) (Bruker Daltonics) and later confirmed by a semiautomatic culture system (Vitek-II). The microorganism recovered was fully susceptible to vancomycin (MIC, 1 g/ml) and linezolid (MIC, 1 g/ml) and showed intermediate susceptibility to tetracyclines (MIC, 4 g/ml) and levofloxacin (MIC, 3 g/ml). The isolate was interpreted as a contaminant, so we continued therapy with levofloxacin.Three days later, due to the persistence of symptoms, the high levels of CRP (23.49 mg/dl), and a high erythrocyte sedimentation rate (ESR) (99 mm/h; normal, Ͻ13 mm/h), a new arthrocentesis was performed, and C. cellulans was again isolated. Linezolid was added based on the lack of response to treatment and suspicion of antibiotic-...

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Section: Case Reportmentioning

confidence: 99%

Septic Arthritis Due to Cellulosimicrobium cellulans

et al. 2011

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“…Even when treated with an antibiotic to which the organisms was presumed susceptible in vitro, there are reports of recurrence and persistence of infections (4,13,16,25,26,33). In cases where there was a foreign body, symptoms disappeared when the foreign body was removed.…”

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confidence: 99%

“…Oerskovia species are widely distributed in the environment and have been isolated from soil, water, and grass cuttings (15), and as with other environmental bacteria, these bacteria are fairly resistant to antimicrobial agents but do not appear to be particularly virulent; no deaths were attributed to the infections (29,33). In vitro, they have exhibited resistance to a range of antimicrobials: penicillins, aminoglycosides, macrolides, and cephalosporins.…”

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confidence: 99%

Clearance of Cellulosimicrobium cellulans Bacteremia in a Child without Central Venous Catheter Removal

Rowlinson¹,

Bruckner²,

Hinnebusch³

et al. 2006

J Clin Microbiol

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Cellulosimicrobium cellulans (formerly known as Oerskovia xanthineolytica) rarely causes human infection. Infections have been reported in immunocompromised hosts or in patients with foreign bodies, such as catheters, where treatment has generally involved removal of the foreign body. We report on a case in which the organism was isolated in multiple blood cultures from a 13-year-old male. After initial therapy failed, treatment with vancomycin and rifampin resulted in infection clearance without removal of the central venous catheter. CASE REPORTA 13-year-old male with a history of midgut volvulus and subsequent short-bowel syndrome, who had received total parenteral nutrition since shortly after birth, presented to the Emergency Department at the University of California-Los Angeles with fever of 39°C, malaise, and bilateral conjunctivitis. The patient had had numerous urinary tract infections and central venous catheter (CVC) line infections in the last few years with organisms such as Micrococcus, coagulase-negative Staphylococcus, Staphylococcus aureus, and Enterococcus species. In the emergency room, blood was drawn from the CVC and from a peripheral vein. Both specimens grew pleomorphic gram-positive rods in aerobic and anaerobic blood culture bottles that were identified as Cellulosimicrobium cellulans. The patient was hospitalized and initially treated with intravenous vancomycin and cefotaxime, which was changed 2 days later to vancomycin and gentamicin. After 3 days in the hospital, the patient became afebrile and was discharged home to continue intravenous vancomycin therapy. Blood cultures (drawn on hospital day 2) became positive for Cellulosimicrobium cellulans after 72 h. Because the patient had been discharged, he was readmitted even though he was afebrile. Due to the difficulty of finding another line of intravenous access for this patient, an attempt to preserve the CVC was made by adding oral rifampin to the treatment regimen. Once rifampin was begun, subsequent blood cultures (drawn 2, 3, and 5 days after readmission, respectively) were negative. The patient was discharged home to complete therapy of 3 weeks on intravenous vancomycin and oral rifampin. A repeat culture obtained 72 h after discontinuation of antibiotics was negative. The patient has not had any recurrent infections with this organism and continues to use the CVC line on a daily basis (1 year posttherapy).

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“…have been reported in almost 30 cases, including bacteremia (Casanova-Roman et al, 2010), endocarditis (Urbina et al, 2003), intra-abdominal sepsis (Borra & Kleinfeld, 1996;Lujan-Zilbermann et al, 1999;Thomas et al, 2007), meningitis (Kailath et al, 1988;Yilmaz et al, 2006), keratitis (Shah et al, 1996), endophthalmitis (JaruAmpornpan et al, 2011) and septic arthritis (MagroCheca et al, 2011) and in association with bone-marrow transplantation (Ellerbroek et al, 1998). In most of the cases, infection was secondary to a medical device or foreign body, and removal of the latter was required for resolution of the infection (Harrington et al, 1996;Kailath et al, 1988).…”

Section: Case Reportmentioning

confidence: 99%

“…In most of the cases, infection was secondary to a medical device or foreign body, and removal of the latter was required for resolution of the infection (Harrington et al, 1996;Kailath et al, 1988). Although two cases have been reported in previously healthy patients (Casanova-Roman et al, 2010;Tucker et al, 2008), infection with C. cellulans has typically been described in immunocompromised patients with human immunodeficiency virus infection (Heym et al, 2005), tumor-induced immunosuppression, post-transplant patients and patients with end-stage renal disease (Ellerbroek et al, 1998;Urbina et al, 2003). The latter was the most frequent underlying condition associated with C. cellulans infections (Rihs et al, 1990), although our patient developed an infection after sustaining acute renal failure, an occurrence that has not been reported elsewhere.…”

Section: Case Reportmentioning

confidence: 99%

Cellulosmicrobium cellulans isolated from a patient with acute renal failure

et al. 2014

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Introduction: Cellulosimicrobium cellulans is a rare human pathogen that is associated with chronic immunosuppression, such as human immunodeficiency virus infection, posttransplantation or end-stage renal disease.Case presentation: A 59-year old man with a past medical history of significant cardiovascular, cerebrovascular and peripheral vascular disease was admitted to the intensive care unit (ICU) with intractable seizures. Physical examination, radiographic imaging and culture results suggested the patient had developed metabolic encephalopathy due to pneumonia caused by Staphylococcus aureus and Moraxella catarrhalis. The patient recovered neurologically with the use of broad-spectrum antibiotics but developed acute renal failure during his stay. Seven days later, he relapsed into seizure activity and two separate blood cultures grew Cellulosimicrobium cellulans. Despite maximal antibiotic therapy, the patient continued to deteriorate. After 16 days, the patient's family withdrew care and he subsequently died. Conclusion:We report the isolation of Cellulosimicrobium cellulans from a patient who developed acute renal failure following a prolonged stay in the ICU for sepsis encephalopathy.Keywords: 16S rRNA sequencing; acute renal failure; antimicrobial therapy; Cellulosimicrobium cellulans. Case reportA 59-year-old man was admitted to the intensive care unit (ICU) with intractable seizures. His past medical history was significant for ischaemic heart disease with two previous myocardial infarctions, peripheral vascular disease requiring a left femoral-femoral bypass and a right femoral-popliteal bypass surgery, chronic obstructive pulmonary disease, dyslipidemia, and a prior admission to the ICU for pneumonia and septicemia. Four months earlier, he had suffered a stroke in the left middle cerebral artery region, leaving him with word-finding difficulties and confusion.On physical examination, the patient was confused, tachycardic (heart rate 120) and tachypneic (respiratory rate of 40). He had decreased air entry and crackles on auscultation of both lungs, and the rest of his physical examination was unremarkable. Laboratory tests showed a normal blood cell count, electrolytes, urea and creatinine. The patient's venous blood gas analysis pH was 7.04, with a partial CO 2 pressure of 96 and an elevated anion gap of 16. He He was intubated and underwent a computed tomography scan of his head, which showed old cerebral infarcts in both hemispheres, generalized atrophy of the brain, and no abscess or haemorrhage. A chest X-ray demonstrated diffuse pulmonary oedema with possible underlying pneumonia. Electroencephalogram recordings revealed moderate metabolic encephalopathy without a clear seizure focus. A lumbar puncture yielded normal results.Empirical treatment with intravenous piperacillin-tazobactam (4.5 g every 6 h) and acyclovir (1500 mg initial

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Oerskovia xanthineolytica endocarditis in a renal transplant patient: case report and review of the literature

Cited by 23 publications

References 18 publications

Septic Arthritis Due to Cellulosimicrobium cellulans

Septic Arthritis Due to Cellulosimicrobium cellulans

Clearance of Cellulosimicrobium cellulans Bacteremia in a Child without Central Venous Catheter Removal

Cellulosmicrobium cellulans isolated from a patient with acute renal failure

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