Septicemia Caused by Dysgonic Fermenter 3 in a Severely Immunocompromised Patient and Isolation of the Same Microorganism from a Stool Specimen

Grob, R; Zbinden, Reinhard; Ruef, C.; Hackenthal, M.; Diesterweg, Ingrid; Altwegg, Martin; Graevenitz, Alexander von

doi:10.1128/jcm.37.5.1617-1618.1999

Cited by 17 publications

(2 citation statements)

References 7 publications

(9 reference statements)

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“…All existing case reports of D. capnocytophagoides bacteremia have occurred in patients with malignancy, and the majority were immunocompromised. Three patients had acute leukemia, were actively receiving chemotherapy, and were neutropenic at the time of diagnosis [ 4 , 8 ]. Of these, one presented with a diarrheal illness and two with fever.…”

Section: Discussionmentioning

confidence: 99%

Dysgonomonas capnocytophagoides Bacteremia in a Patient With Stage IV Colon Adenocarcinoma

Schall

Blyth²,

McCarthy³

2021

Cureus

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Dysgonomonas capnocytophagoides bacteremia is a rare clinical entity described in only five case reports. Difficulties in the identification and intrinsic multidrug resistance (MDR) of the organism make diagnosis and treatment challenging. We present a case of D. capnocytophagoides bacteremia which highlights the diagnostic and treatment challenges posed by this organism. The case also contributes to the nascent understanding of the clinical profile of patients with D. capnocytophagoides infection and the antimicrobial susceptibility of the organism.A 56-year-old male with advanced colon adenocarcinoma on palliative fluorouracil, leucovorin, and irinotecan (FOLFIRI) presented with abdominal pain. He had been discharged recently following an ICU admission for neutropenic fever with diarrhea and polymicrobial bacteremia resulting in sepsis. Diarrhea resolved during hospitalization. Mediport was retained, surveillance blood cultures remained negative, and he completed 14 days of levofloxacin. Upon readmission for abdominal pain, vital signs were normal and neutropenia had resolved. A Gram-negative rod grew from blood cultures drawn peripherally and from the port with no differential time-to-positivity. Multiple testing platforms were used in an attempt to identify the organism, to include the VERIGENE® Gram-negative blood culture test, matrix-assisted laser desorption ionization-time of flight (MALDI-TOF) mass spectrometry, VITEK ® 2 GN ID, and the Thermo Scientific™ RapID™ NH System (Thermo Scientific, Waltham, MA). Test results from all platforms were either inconclusive or contradictory in their identification of the organism, making the determination of appropriate treatment difficult. Given inconsistent results on multiple testing platforms, the isolate was sent for whole genome sequencing (WGS). Additional workup performed during the hospitalization included a diagnostic paracentesis without evidence of spontaneous bacterial peritonitis, transesophageal echocardiogram without evidence of infective endocarditis, and dental evaluation without evidence of the infectious source. Abdominal CT showed nonspecific terminal ileitis. He was treated for presumed HACEK bacteremia and was transitioned from piperacillin-tazobactam to ceftriaxone to complete a two-week course at hospital discharge. He also received a seven-day course of doxycycline for concomitant, mild lower extremity cellulitis which resolved during hospitalization. Ultimately, antimicrobial susceptibility testing which resulted following discharge was not consistent with the HACEK organism. Testing demonstrated resistance to multiple antimicrobials including ceftriaxone, as well as susceptibility to trimethoprimsulfamethoxazole (TMP/SMX). WGS ultimately identified the organism as D. capnocytophagoides. Despite ceftriaxone resistance, he reported feeling well at follow-up with negative surveillance blood cultures. This patient shares several features with the few patients previously identified with D. capnocytophagoides bacteremia, including malignancy, re...

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Section: Discussionmentioning

confidence: 99%

Dysgonomonas capnocytophagoides Bacteremia in a Patient With Stage IV Colon Adenocarcinoma

Schall

Blyth²,

McCarthy³

2021

Cureus

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“…D. capnocytophagoides usually demonstrates resistance to various antimicrobial agents (4,5), and its natural habitat is considered to be the human gastrointestinal tract (15). In the case under study, sulbactam-cefoperazone was administered 4 days after admission.…”

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confidence: 99%

Characterization and Antimicrobial Susceptibility of <i>Dysgonomonas capnocytophagoides</i> Isolated from Human Blood Sample

et al. 2008

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Dysgonomonas capnocytophagoides belongs to a group of facultative anaerobic Gram-negative coccobacilli that was formerly designated CDC group DF-3. We evaluated the characteristics of this microbe and its susceptibility to antimicrobial agents. In this study, D. capnocytophagoides was isolated by anaerobic blood cultures from a 78-year-old male with pancreatic cancer, ischemic heart disease, and diabetes mellitus, who also showed symptoms of cholangitis. The isolated strain demonstrated resistance to various β-lactams, erythromycin, aminoglycosides, and fluoroquinolones, but was susceptible to sulfamethoxazole-trimethoprim, clindamycin, minocycline, and chloramphenicol. The results of all biochemical tests and the homology of the 16S rRNA gene were consistent with previous reports of D. capnocytophagoides.

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Dysgonomonas

Olsen¹

2015

Bergey's Manual of Systematics of Archaea and Bacteria

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Dys.go.no.mo'nas. Gr. pref. dys ‐ with notion of hard, bad, unlucky; Gr. n. gonos that which is begotten, reproduction; Gr. fem. n. monas a monad, unit; N.L. fem. n. Dysgonomonas intended to mean a weakly growing monad. Bacteroidetes / Bacteroidia / Bacteroidales / Porphyromonadaceae / Dysgonomonas Coccobacilli to short rods. Nonmotile. Gram‐negative. Facultatively anaerobic. Colonies are 1–2 mm in diameter, nonadherent, entire, gray–white, smooth, and nonhemolytic and have a slight aromatic odor. Growth is not observed on MacConkey agar. Requires X factor for growth. May be catalase‐positive or ‐negative. Oxidase‐negative. Glucose is fermented, producing acid but no gas. Alkaline phosphatase is generated but not arginine dihydrolase. Nitrate is not reduced. H 2 S and acetoin are not produced. Esculin may not be hydrolyzed; gelatin and urea are not hydrolyzed. Indole may be produced. Long‐chain cellular fatty acids include straight‐chain saturated, anteiso‐ and iso‐methyl branched and 3‐hydroxy types. Isolated from human clinical specimens and stools. DNA G + C content ( mol %): 38 ( T m ). Type species : Dysgonomonas gadei Hofstad, Olsen, Eribe, Falsen and Lawson 2000, 2194 VP .

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Septicemia Caused by Dysgonic Fermenter 3 in a Severely Immunocompromised Patient and Isolation of the Same Microorganism from a Stool Specimen

Cited by 17 publications

References 7 publications

Dysgonomonas capnocytophagoides Bacteremia in a Patient With Stage IV Colon Adenocarcinoma

Dysgonomonas capnocytophagoides Bacteremia in a Patient With Stage IV Colon Adenocarcinoma

Characterization and Antimicrobial Susceptibility of <i>Dysgonomonas capnocytophagoides</i> Isolated from Human Blood Sample

Dysgonomonas

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