Sepsis caused by Chromobacterium violaceum – probably the first case in Europe, or <i>Macbeth</i> read anew

Abstract

Rare diseases, almost by definition, present us with diagnostic as well as therapeutic difficulties as. They also include infectious diseases outside endemic areas. Without expecting them, we are not preparing to fight them. Like Macbeth, we feel safe, convinced that tropical diseases do not reach us, like Birnam forest towards his castle. Nevertheless, the forest moved according to the prophecy of the three witches, and in a similar way tropical flora is moving towards us according to the predictions of environmentalists. This is illustrated by the history of the presented patient, who was admitted to hospital because of sepsis caused by Chromobacterium violaceum (CV), a Gram-negative facultatively anaerobic, oxidasepositive bacterium producing a dark violet antioxidant pigment called violacein. This is probably the first documented case report of sepsis in this part of the world. To the best of the authors' knowledge, the patient is the first to require dialysis after Chromobacterium violaceum infection.

Chromobacterium violaceum causing disseminated soft tissue and pulmonary abscesses in a traveller returning from the Azores

“…Predisposing conditions appear to be chronic granulomatous disease, glucose-6-phosphatase deficiency, and diabetes [ 1, 7 ]. It is an infection slightly more common in men (reported in some literature as 55.6 %), and which usually affects people between the ages of 16–66 years of age [ 3 ]. Contact with contaminated fresh water is also a documented associated risk factor, which reflects swimming in outdoor hot springs in our case [ 8 ].…”

“…It was first described in 1872 as a tropical pathogen that was potentially harmful to people and animals [ 2 ]. It produces a characteristic dark violet antioxidant pigment called violacein, which produces a purple colouring in colony growths [ 3 ]. It is a rare infection with fewer than 300 cases reported in the literature [ 4 ].…”

Chromobacterium violaceum causing deadly sepsis

“…It is motile, Gram negative, facultative anaerobic bacillus and took its name from the purple pigment – violacein ( 8 ). The fact that there are only few reports of human infections with this organism is a surprise, given the ease with which this organism is isolated from the soil and stagnant water bodies in the tropics and subtropics ( 9 ). Mostly human infection is seen in paediatric and young adults ( 3 ).…”

Integrated into Environmental Biofilm Chromobacterium vaccinii Survives Winter with Support of Bacterial Community

“…Reports of environmental Chromobacterium species isolation in Europe are rare: one in Poland (Chromobacterium violaceum from Ixodes ricinus ticks) and evidence of C. vaccinii isolation from bog in Tver region, Russia [3,4]. Moreover, numerous clinical cases of infections in Europe due to Chromobacterium species were discussed in a prism of global warming, but primary sources of infection and natural reservoirs of pathogenic Chromobacterium species remain undiscovered [5]. While members of the Chromobacterium genus are still considered as tropical/subtropical bacteria with poor viability at low temperatures, this is still questionable if changing environment and other processes affect the worldwide distribution of "tropical" Chromobacterium species or an abundance of these species are underestimated in the temperate climate zone.…”