We describe a case of Negativicoccus succinicivorans bacteremia in an adult man with hemochromatosis and acute pancreatitis. Conventional phenotypic tests and commercial identification systems failed to definitively identify the tiny anaerobic Gram-negative coccus isolated from two sets of blood cultures. The bacterium was identified by 16S rRNA gene sequencing and analysis using the SmartGene Integrated Database Network System software. This is the first published report of the recovery of this organism from a patient with invasive infection.
CASE REPORTA 57-year-old man with hemochromatosis was admitted to the hospital in June 2008 with acute pancreatitis. He had a history of chronic alcohol abuse. He complained of abdominal pain and diarrhea. The physical examination revealed a temperature of 38.4°C and lower abdominal tenderness without rebound tenderness. Computerized tomography scanning revealed peripancreatic inflammation consistent with pancreatitis. A complete blood count and differential showed anemia (hemoglobulin ϭ 118 g/liter), thrombocytopenia (68 ϫ 10 9 cells/ml), and a normal white blood cell count (6.9 ϫ 10 9 cells/ml), with a normal level of polymorphonuclear cells but a low level of lymphocytes. He had mild renal dysfunction, with a serum creatinine level of 111 g/liter. Pancreatitis was confirmed, and he had an increasingly elevated lipase level (from 225 to 978 IU), documented within the initial 48 h in the hospital, and associated mild hepatocellular dysfunction with an elevated gamma-glutamyl transferase level (587 g/liter). The total bilirubin was also mildly increased at 16 g/liter. Stool tests were negative for Clostridium difficile toxins (A and B), Salmonella, Shigella, Campylobacter, Escherichia coli O157, Aeromonas, and Plesiomonas, and a Giardia/Cryptosporidium enzyme immunoassay (EIA) was negative.Two sets of blood samples were collected and cultured with BacT/Alert blood culture system (bioMérieux Canada, Laval, Quebec, Canada) FA (aerobic) and FN (anaerobic) bottles, and the FN bottles in both sets were positive, as described below. Supportive therapy included administration of antibiotics (one dose of cefuroxime and then piperacillin-tazobactam), and the patient recovered uneventfully after 4 days of hospitalization and was discharged.