Sepsis grave lié à un abcès pulmonaire avec bactériémie à Elizabethkingia miricola

González, C.; Coolen-Allou, Nathalie; Allyn, Jérôme; Estève, Jean-Baptiste; Belmonte, Olivier; Allou, Nicolas

doi:10.1016/j.medmal.2015.10.011

Cited by 16 publications

(10 citation statements)

References 5 publications

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“…E. miricola should be considered a possible cause of infection (latent or apparent) in the oral cavity, spread by translocation or inhalation, and leading to severe pulmonary and bloodstream superinfection [ 1 , 2 , 11 , 12 ] in patients with a late diagnosis of CVID, periodontitis and previous multi-antibiotic treatment. E. miricola is isolated from sterile sites during the late phase of the infectious process.…”

Section: Discussionmentioning

confidence: 99%

“…Despite the clinical importance of E. miricola infections, this bacterium has not been characterized epidemiologically, as its route of transmission and portal of entry remain poorly understood. This bacterium usually induces pneumonia and lower respiratory tract infections, with the latter consisting of the formation of pulmonary nodules followed by sepsis [ 1 ], lung abscess and pleural effusion [ 2 ], or severe nosocomial pneumonia [ 3 ]. However, the pathogenesis of established infections has not been clarified.…”

Section: Introductionmentioning

confidence: 99%

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Elizabethkingia miricola as an opportunistic oral pathogen associated with superinfectious complications in humoral immunodeficiency: a case report

et al. 2017

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Background Elizabethkingia miricola is a rare Gram-negative bacterium found in water and clinical specimens. Typical culturing methods often misidentify Elizabethkingia spp. as Flavobacterium or Chryseobacterium. Although diagnosis is based on culturing samples taken from sterile sites, such as blood, a proper identification of this bacterium requires an expertise that goes beyond the capabilities of a typical clinical laboratory.Case presentationA 35-year-old woman diagnosed with common variable immunodeficiency was admitted to our center. Previous treatment with antibiotics (amoxicillin plus clavulanate, first and third generation of cephalosporins, macrolides) and systemic corticosteroids (up to 120 mg/day of prednisolone) failed to arrest the spread of inflammation. Gingival recession was observed in her oral cavity, resulting in an apparent lengthening of her teeth. In addition to typical commensal bacteria, including streptococci and neisseriae, strains of Rothia mucilaginosa and Elizabethkingia miricola were identified upon a detailed microbiological examination using a MALDI-TOF MS Biotyper system. The presence of the latter strain correlated with severe periodontitis, lack of IgA in her saliva and serum, a very low IgG concentration (< 50 mg/dl), IgM-paraproteinemia, decreases in C3a and C5a and microvascular abnormality. High-dose immunoglobulin (to maintain IgG > 500 mg/dl) and targeted levofloxacin treatment resulted in immune system reconstitution, oral healing, and eradication of the Elizabethkingia infection.Conclusions E. miricola rarely causes disease in healthy individuals. However, the overgrowth of commensal bacteria, lack of IgG/IgA, microvasculopathy and complement cascade activation in patients with humoral immunodeficiency may facilitate Elizabethkingia invasion. Overuse of antibiotics, particularly beta-lactams, may cause mucosal colonization by E. miricola, followed by its multiplication combined with periodontitis that prompts bacterial translocation. MALDI-TOF Biotyper analysis may become a method of choice for identification of Elizabethkingia infections.Electronic supplementary materialThe online version of this article (10.1186/s12879-017-2886-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Elizabethkingia miricola as an opportunistic oral pathogen associated with superinfectious complications in humoral immunodeficiency: a case report

et al. 2017

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“…One of the first reports of E. miricola infection was of positive growth in blood and sputum cultures of a septic patient whom had recently undergone a stem-cell transplant for mantle-cell lymphoma. Since then it has been reported in only a handful of cases, including septicaemia in a young patient with alcoholic pancreatitis and in the sputum of a septic patient with pulmonary abscesses 2 , 3 . A degree of immunocompromise is a unifying feature in these cases, and the long-term oral corticosteroids required for treatment of ABPA in the present case may have predisposed to infection with E. miricola .…”

Section: Discussionmentioning

confidence: 99%

“…Originally identified as belonging to the Chryseobacterium genus, it has since been re-classified and is closely related to Elizabethkingia meningoseptica (previously C. meningosepticum ). E. miricola has been demonstrated to be pathogenic, with reports of bacteraemia resulting in sepsis and pulmonary abscesses 2 , 3 . Here, we report the presence of E. miricola in the sputum of a patient with cystic fibrosis (CF).…”

Section: Introductionmentioning

confidence: 99%

Case Report: First report of Elizabethkingia miricola infection in a patient with cystic fibrosis

Frost

Nazareth

2018

F1000Res

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Elizabethkingia miricola is a rare non-fermenting Gram-negative rod that has previously been reported to be associated with blood stream and pulmonary abscess infections, but never before in cystic fibrosis (CF). Here we present the first reported case of Elizabethkingia miricola infection in a patient with CF and discuss the management options. We describe a patient with CF in whom we observed clinical and spirometric evidence of pulmonary exacerbation with the associated growth of E. miricola in sputum culture. The period of clinical instability was observed to coincide with the obtainment of four sputum samples from which E. miricola was cultured; improvement was seen following treatment with ciprofloxacin and the subsequent eradication of E. miricola. We conclude that E. miricola is able to survive in the CF lung and in this case was associated with pulmonary exacerbation. Empirical treatment with fluoroquinolones is appropriate, based on our experience.

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“…Later on, E. miricola was isolated from the blood sample of a young female with alcoholic pancreatitis[6]. More recently, E. miricola has been isolated from a patient with severe sepsis and pulmonary abscess[9]. In both the above cases, the isolate was identified by MALDI-TOF.…”

Section: Discussionmentioning

confidence: 99%

Elizabethkingia miricola: A rare non-fermenter causing urinary tract infection

Gupta¹,

Zaman²,

Mohan³

et al. 2017

WJCC

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Elizabethkingia miricola (E. miricola) is a gram-negative non-fermentative bacterium which is rarely encountered. It is usually misidentified or considered as a contaminant in routine microbiology laboratories due to the limitations in conventional biochemical techniques. However, with the advent of the matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF-MS), the identification of non-fermenters has become easy and this has led to enhanced understanding of the clinical significance of these uncommonly isolated microorganisms. The genus Elizabethkingia has only two species E. meningoseptica and E. miricola. Both of these organisms are known to be multi-drug resistant and therefore, their accurate identification and antimicrobial susceptibility testing are necessary prior to the initiation of appropriate therapy. In the world literature till date, only 3 cases of sepsis caused by E. miricola have been reported. We present the first case of E. miricola association with urinary tract infection.

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Sepsis grave lié à un abcès pulmonaire avec bactériémie à Elizabethkingia miricola

Cited by 16 publications

References 5 publications

Elizabethkingia miricola as an opportunistic oral pathogen associated with superinfectious complications in humoral immunodeficiency: a case report

Elizabethkingia miricola as an opportunistic oral pathogen associated with superinfectious complications in humoral immunodeficiency: a case report

Case Report: First report of Elizabethkingia miricola infection in a patient with cystic fibrosis

Elizabethkingia miricola: A rare non-fermenter causing urinary tract infection

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