Recurrent &lt;i&gt;Helicobacter cinaedi&lt;/i&gt; Cellulitis and Bacteremia in a Patient with Systemic Lupus Erythematosus

Kikuchi, Hirotoshi; Asako, Kurumi; Tansho, Shigeru; Ueda, Takane; Koshio, Osamu; Ubagai, Tsuneyuki; Asahara, Miwa; Kawakami, Sayoko; Ono, Yasuo

doi:10.2169/internalmedicine.51.8149

Cited by 22 publications

(14 citation statements)

References 17 publications

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“…H. cinaedi might have presented as transient bacteremia in immunocompromised patients, especially in the 27 patients with only fever. Also, recent studies suggested that H. cinaedi may cause recurrent bacteremia (12)(13)(14), which was reported in 15 patients (24%) in the current study. The reason recurrent bacteremia occurs in specific cases remains unknown; however, H. cinaedi in the gastrointestinal tract may be associated with recurrent bacteremia.…”

Section: Discussionsupporting

confidence: 64%

Clinical Characteristics of Bacteremia Caused by Helicobacter cinaedi and Time Required for Blood Cultures To Become Positive

et al. 2014

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The aim of this study was to clarify the clinical characteristics of patients with Helicobacter cinaedi bacteremia and the time required for blood cultures to become positive. The medical records of all patients with H. cinaedi bacteremia at Toranomon Hospital and Toranomon Hospital Kajigaya between March 2009 and March 2013 were retrospectively reviewed. Sixty-three patients, 34 men and 29 women with a median age of 67 years (range, 37 to 88 years), were diagnosed with H. cinaedi bacteremia. A total of 51,272 sets of blood cultures were obtained during the study period, of which 5,769 sets of blood cultures were positive for some organism and 126 sets were H. cinaedi positive. The time required for blood cultures to become positive for H. cinaedi was <5 days in 69 sets (55%) and >5 days in 57 sets (45%). Most patients had an underlying disease, including chronic kidney disease (21 cases), solid tumor (19 cases), hematological malignancy (13 cases), diabetes mellitus (8 cases), chronic liver disease (6 cases), and postorthopedic surgery (3 cases). Only 1 patient had no apparent underlying disease. The clinical symptoms included cellulitis in 24 cases, colitis in 7 cases, and fever only in 27 cases, including 7 cases of febrile neutropenia. The 30-day mortality rate of H. cinaedi bacteremia was 6.3%. In conclusion, most cases of H. cinaedi bacteremia occurred in immunocompromised patients. We might have overlooked nearly half of the H. cinaedi bacteremia cases if the duration of monitored blood culture samples had been within 5 days. Therefore, when clinicians suspect H. cinaedi bacteremia, the observation period for blood cultures should be extended.

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Section: Discussionsupporting

confidence: 64%

Clinical Characteristics of Bacteremia Caused by Helicobacter cinaedi and Time Required for Blood Cultures To Become Positive

et al. 2014

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“…In common with other intestinal pathogens, EHS have been found to translocate resulting in bacteremia and other secondary infections such as cellulitis and arthritis (reviewed in O' Rourke et al 2001;Fox 2002;Solnick 2003;Freeman and Holland 2007;Minauchi et al 2010;Kikuchi et al 2012;Rimbara et al 2012). While H. cinaedi is the predominant organism identified in these infections other cases have been attributed to H. bilis (previously referred to as flexispira), H. fennelliae and more recently H. canis (Leemann et al 2006;Alon et al 2010;Turvey et al 2012).…”

Section: Enterohepatic Infectionsmentioning

confidence: 99%

The Family Helicobacteraceae

et al. 2014

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“…H. cinaedi and H. fennelliae also cause bacteraemia in patients with chronic renal failure, autoimmune diseases and solid organ cancers (Nishine et al , 2007; Matsumoto et al , 2007; Rimbara et al , 2013b; Saito et al , 2016). There are several reports of recurrent H. cinaedi bacteraemia in immunocompromised hosts (Sullivan et al , 1997; Mammen et al , 1995; Kikuchi et al , 2012; Uçkay et al , 2006), which is treated with prolonged antibiotic therapy to prevent further recurrence (Kiehlbauch et al , 1994; Tee et al , 1996; Sullivan et al , 1997). However, only a few cases of recurrent H. fennelliae bacteraemia have been reported in Japan (Saito et al , 2016), and there are no guidelines regarding the choice or duration of antimicrobial treatment and prevention of recurrence for H. fennelliae infection.…”

Section: Introductionmentioning

confidence: 99%

Successful treatment of recurrent Helicobacter fennelliae bacteraemia by selective digestive decontamination with kanamycin in a lung cancer patient receiving chemotherapy

et al. 2016

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Introduction:Helicobacter fennelliae is an enterohepatic Helicobacter species causing bacteraemia in immunocompromised hosts. Only a few cases of recurrent H. fennelliae bacteraemia have been reported in Japan and there are no guidelines regarding antimicrobial treatment for H. fennelliae infection.Case presentation:H. fennelliae bacteraemia was observed in a patient receiving platinum-based chemotherapy for lung cancer. To prevent recurrence, the patient received antibiotic therapy with cefepime, amoxicillin and doxycycline for 6 weeks, which is similar to the therapy for Helicobacter cinaedi bacteraemia. Bacteraemia recurred despite the long-term antibiotic therapy. We hypothesized that the H. fennelliae bacteraemia originated from endogenous infection in the intestinal tract due to the long-term damage of the enteric mucosa by platinum-based drugs and performed selective digestive decontamination (SDD) with kanamycin. Bacteraemia did not recur after SDD.Conclusion:Our observations indicate that clinicians should be aware of possible recurrent H. fennelliae bacteraemia, which could be effectively prevented by SDD with kanamycin.

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Recurrent <i>Helicobacter cinaedi</i> Cellulitis and Bacteremia in a Patient with Systemic Lupus Erythematosus

Cited by 22 publications

References 17 publications

Clinical Characteristics of Bacteremia Caused by Helicobacter cinaedi and Time Required for Blood Cultures To Become Positive

Clinical Characteristics of Bacteremia Caused by Helicobacter cinaedi and Time Required for Blood Cultures To Become Positive

The Family Helicobacteraceae

Successful treatment of recurrent Helicobacter fennelliae bacteraemia by selective digestive decontamination with kanamycin in a lung cancer patient receiving chemotherapy

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