Pneumonia due to Stomatococcus mucilaginosus in an AIDS patient: case report and literature review

Lambotte, Olivier; Debord, T.; Soler, C.; Roué, R.

doi:10.1111/j.1469-0691.1999.tb00116.x

Cited by 12 publications

(8 citation statements)

References 13 publications

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“…Reports of bacteremia, central venous catheter sepsis, pneumonia, and meningitis with S. mucilaginosus have been seen in neutropenic patients (6-8, 16, 17). S. mucilaginosus pneumonia has also been reported in patients with HIV infection and in a patient following liver transplant (7,11,16). Few cases of infections by S. mucilaginosus have been reported in immunocompetent host (10).…”

Section: Discussionmentioning

confidence: 95%

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Induction of Cyclooxygenase-2 Signaling by Stomatococcus mucilaginosus Highlights the Pathogenic Potential of an Oral Commensal

Yuan

Panchal

Syed

et al. 2013

The Journal of Immunology

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Stomatococcus mucilaginosus is an oral commensal that has been occasionally reported to cause severe infections in immunocompromised patients. There is no information about the pathogenic role of S. mucilaginosus in airway infections. In a cohort of 182 subjects with bronchiectasis, we found that 9% were colonized with S. mucilaginosus in their lower airways by culture growth from bronchoalveolar lavage. To address the pathogenic potential of S.mucilaginosus, we developed a murine model of S. mucilaginosus lung infection. Intratracheal injection of S. mucilaginosus in C57BL/6 mice resulted in a neutrophilic influx with production of proinflammatory cytokines, chemokines, and lipid mediators, mainly PGE2 with induction of cyclooxygenase-2 (COX-2) in the lungs. Presence of TLR2 was necessary for induction of COX-2 and production of PGE2 by S. mucilaginosus. TLR2-deficient mice showed an enhanced clearance of S. mucilaginosus compared with wild-type mice. Administration of PGE2 to TLR2−/− mice resulted in impaired clearance of S. mucilaginosus, suggesting a key role for COX-2–induced PGE2 production in immune response to S. mucilaginosus. Mechanistically, induction of COX-2 in macrophages was dependent on the p38-ERK/MAPK signaling pathway. Furthermore, mice treated with S. mucilaginosus and Pseudomonas aeruginosa showed an increased mortality compared with mice treated with PA103 or S. mucilaginosus alone. Inhibition of COX-2 significantly improved survival in mice infected with PA103 and S. mucilaginosus. These data provide novel insights into the bacteriology and personalized microbiome in patients with bronchiectasis and suggest a pathogenic role for S. mucilaginosus in patients with bronchiectasis.

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Section: Discussionmentioning

confidence: 95%

“…mucilaginosus is an encapsulated Gram-positive coccus found in oral cavity as part of the normal flora that has been occasionally reported to cause severe infections in immunocompromised patients (6)(7)(8)(9)(10)(11)(12). It has been implicated in the causation of endocarditis (13,14), sepsis, and catheter-related bacteremia (8,15).…”

mentioning

confidence: 99%

Induction of Cyclooxygenase-2 Signaling by Stomatococcus mucilaginosus Highlights the Pathogenic Potential of an Oral Commensal

Yuan

Panchal

Syed

et al. 2013

The Journal of Immunology

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“…Moreover, four of five patients received Pneumocystis jirovecii prophylaxis with trimethoprim/sulfamethoxazole, which might also be a risk factor per se for developing a Rothia mucilaginosa infection . In addition, there seems to be an emerging resistance of Rothia mucilaginosa to trimethoprim, as it was also found in one of the isolated strains of our patients …”

Section: Discussionmentioning

confidence: 52%

Rothia mucilaginosa bacteremia: A 10‐year experience of a pediatric tertiary care cancer center

Poyer

Friesenbichler

Hutter

et al. 2019

Pediatric Blood & Cancer

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Rothia mucilaginosa is part of the oral and upper respiratory tract flora. Usually, this gram‐positive coccus is not pathogenic; however, in the setting of immunosuppressed hosts, it can cause life‐threatening infections as an opportunistic pathogen. Among a cohort of 1511 hematologic‐oncologic patients at a pediatric tertiary care cancer center, we identified five cancer patients (0.35%) within a period of 10 years having a proven Rothia mucilaginosa bacteremia (1 culture positive: n = 3/5; > 1 culture positive: n = 2/5). With prompt and adequate antibiotic treatment, infection resolved rapidly before recovery of neutrophils and without any sequelae, suggesting that Rothia mucilaginosa bacteremia without organ involvement is not exceptionally problematic in pediatric cancer patients.

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“…In our case, levofloxacin may have been more active than in vitro susceptibility results on ICOs would have led us to expect. Outcomes of R. mucilaginosa pneumonia treated with levofloxacin are generally favorable, but non-attributable mortality has been found in patients with serious underlying disease [6, 7, 9]. …”

Section: Discussionmentioning

confidence: 99%

Rothia mucilaginosaPneumonia Diagnosed by Quantitative Cultures and Intracellular Organisms of Bronchoalveolar Lavage in a Lymphoma Patient

et al. 2013

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Rothia mucilaginosa is a gram-positive coccus of the family Micrococcaceae. R. mucilaginosa is considered a part of the normal flora of the human oropharynx and upper respiratory tract and lower respiratory tract infections attributable to R. mucilaginosa are not frequent. We present a case of pneumonia, in which the R. mucilaginosa infection was diagnosed by quantitative cultures of a bronchoalveolar lavage (BAL) specimen. A 46-yr-old woman with B lymphoblastic lymphoma was admitted to the hospital for scheduled chemotherapy. Her chest computed tomography (CT) scan revealed bilateral multifocal nodular and patchy consolidation in both lungs. Investigation of the BAL specimen revealed that 7% of leukocytes had intracellular gram-positive cocci. The quantitative cultures of the BAL specimen grew mucoid, non-hemolytic, and grayish convex colonies on blood agar at a count of approximately 200,000 colony-forming units/mL. The colonies were identified as R. mucilaginosa. The patient was empirically treated with levofloxacin for 7 days, after which findings on the chest radiograph and CT scan improved. She was discharged with improvement on hospital day 46. To our knowledge, this is the first report of R. mucilaginosa pneumonia diagnosed in Korea. Quantitative culture of BAL specimen and examination of intracellular organisms are crucial for assessing the clinical significance of R. mucilaginosa recovered from the lower respiratory tract.

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Pneumonia due to Stomatococcus mucilaginosus in an AIDS patient: case report and literature review

Cited by 12 publications

References 13 publications

Induction of Cyclooxygenase-2 Signaling by Stomatococcus mucilaginosus Highlights the Pathogenic Potential of an Oral Commensal

Induction of Cyclooxygenase-2 Signaling by Stomatococcus mucilaginosus Highlights the Pathogenic Potential of an Oral Commensal

Rothia mucilaginosa bacteremia: A 10‐year experience of a pediatric tertiary care cancer center

Rothia mucilaginosaPneumonia Diagnosed by Quantitative Cultures and Intracellular Organisms of Bronchoalveolar Lavage in a Lymphoma Patient

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