日本語フィールド
著者：Fujita M, Ureshino H, Kimura S題名：Helicobacter cinaedi bacteremia in a patient with primary central nervous system lymphoma発表情報：eJHaem 巻: 2 号: 4 ページ: 875–876キーワード：概要：A 61-year-old man diagnosed with primary central nervous system lymphoma (PCNSL) was admitted to our hospital for the second cycle of rituximab, methotrexate, procarbazine, and vincristine (R-MPV) treatment. On day 6 of the second cycle of R-MPV, erythema nodosum lesions emerged at his left leg and right wrist joint, and then disappeared after initiation of loxoprofen sodium hydrate. No fever was observed in the first or second cycle of R-MPV. On day 1 of the third cycle of R-MPV, erythema appeared on the left hip and left arm. The arm lesions disappeared rapidly after initiation of topical betamethasone, whereas the hip lesions remained. On day 5, the patient developed a high fever (39.2°C), and blood culture was performed. The patient did not suffer from neutropenia (white cell count, 5.2 × 109/μl; neutrophils, 77.6%), diarrhea, or joint pain. After initiation of levofloxacin, fever was ameliorated within 24 h, but the erythema at the left hip was not ameliorated. Gram-negative spiral bacilli were isolated (Figure 1A) by 5 day blood culture, and swarming colonies generated a thin film on Brucella agar (Figure 1B), indicating Helicobacter cinaedi. Subsequently, the bacteria were confirmed to be H. cinaedi by mass spectrometry. A 1-week course of intravenous ampicillin was administered, followed by a 3-week course of oral amoxicillin and a subsequent 3-week course of oral kanamycin. After initiation of antibiotics, the erythema in the left hip disappeared rapidly without relapse.
Helicobacter cinaedi, a Gram-negative spiral-shaped bacterium that primarily resides in the gastrointestinal tract, can cause bacteremia accompanied by skin lesions, particularly in immunodeficient individuals. Helicobacter cinaedi is a slow-growing bacteria that is difficult to detect by conventional blood culture due to the short incubation time of this procedure (>5-day incubation time is required in half of cases). Accordingly, H. cinaedi may be an underdiagnosed cause of febrile illness. Physicians should consider the possibility of H. cinaedi bacteremia when patients with hematological malignancy complain of febrile illness with skin lesions. Spiral-shaped Gram stain findings and thin film-like colony formation on Brucella agar may help physicians to diagnose H. cinaedi infection.抄録：英語フィールド
Author：Fujita M, Ureshino H, Kimura STitle：Helicobacter cinaedi bacteremia in a patient with primary central nervous system lymphomaAnnouncement information:eJHaem Vol: 2 Issue: 4 Page: 875–876An abstract：A 61-year-old man diagnosed with primary central nervous system lymphoma (PCNSL) was admitted to our hospital for the second cycle of rituximab, methotrexate, procarbazine, and vincristine (R-MPV) treatment. On day 6 of the second cycle of R-MPV, erythema nodosum lesions emerged at his left leg and right wrist joint, and then disappeared after initiation of loxoprofen sodium hydrate. No fever was observed in the first or second cycle of R-MPV. On day 1 of the third cycle of R-MPV, erythema appeared on the left hip and left arm. The arm lesions disappeared rapidly after initiation of topical betamethasone, whereas the hip lesions remained. On day 5, the patient developed a high fever (39.2°C), and blood culture was performed. The patient did not suffer from neutropenia (white cell count, 5.2 × 109/μl; neutrophils, 77.6%), diarrhea, or joint pain. After initiation of levofloxacin, fever was ameliorated within 24 h, but the erythema at the left hip was not ameliorated. Gram-negative spiral bacilli were isolated (Figure 1A) by 5 day blood culture, and swarming colonies generated a thin film on Brucella agar (Figure 1B), indicating Helicobacter cinaedi. Subsequently, the bacteria were confirmed to be H. cinaedi by mass spectrometry. A 1-week course of intravenous ampicillin was administered, followed by a 3-week course of oral amoxicillin and a subsequent 3-week course of oral kanamycin. After initiation of antibiotics, the erythema in the left hip disappeared rapidly without relapse.
Helicobacter cinaedi, a Gram-negative spiral-shaped bacterium that primarily resides in the gastrointestinal tract, can cause bacteremia accompanied by skin lesions, particularly in immunodeficient individuals. Helicobacter cinaedi is a slow-growing bacteria that is difficult to detect by conventional blood culture due to the short incubation time of this procedure (>5-day incubation time is required in half of cases). Accordingly, H. cinaedi may be an underdiagnosed cause of febrile illness. Physicians should consider the possibility of H. cinaedi bacteremia when patients with hematological malignancy complain of febrile illness with skin lesions. Spiral-shaped Gram stain findings and thin film-like colony formation on Brucella agar may help physicians to diagnose H. cinaedi infection.