Recurrent Bordetella holmesii Bacteremia and Nasal Carriage in a Patient Receiving Rituximab
| Autor: | Marylin Lecso, Jean Gabarre, Nicole Guiso, Eric Caumes, François Bricaire, Liem Binh Luong Nguyen, Loïc Epelboin, Sophie Guillot |
|---|---|
| Přispěvatelé: | CHU Pitié-Salpêtrière [AP-HP], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Service d'Hématologie clinique [CHU Pitié-Salpêtrière], Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU)-Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP), Centre National de Référence de la Coqueluche et autres bordetelloses (CNR), Institut Pasteur [Paris], Service des maladies infectieuses et tropicales [CHU Pitié-Salpêtrière], Assistance publique - Hôpitaux de Paris (AP-HP) (AP-HP)-Sorbonne Université (SU), Institut Pasteur [Paris] (IP) |
| Jazyk: | angličtina |
| Rok vydání: | 2013 |
| Předmět: |
Microbiology (medical)
medicine.medical_specialty Letter MESH: Bordetella Infections/diagnosis Epidemiology lcsh:Medicine MESH: Bordetella/isolation & purification lcsh:Infectious and parasitic diseases 03 medical and health sciences respiratory infections 0302 clinical medicine rituximab [SDV.MHEP.MI]Life Sciences [q-bio]/Human health and pathology/Infectious diseases Internal medicine medicine pneumonia lcsh:RC109-216 MESH: Antibodies Monoclonal Murine-Derived/administration & dosage 030212 general & internal medicine cellulitis Letters to the Editor bacteria ComputingMilieux_MISCELLANEOUS Bordetella holmesii First episode 0303 health sciences biology 030306 microbiology business.industry lcsh:R [SDV.IMM.IMM]Life Sciences [q-bio]/Immunology/Immunotherapy Amoxicillin biology.organism_classification medicine.disease Trimethoprim MESH: Antineoplastic Agents/administration & dosage MESH: Bacteremia/diagnosis 3. Good health Surgery Infectious Diseases Cellulitis Bacteremia Ceftriaxone Chills MESH: Nose/microbiology medicine.symptom business medicine.drug |
| Zdroj: | Emerging Infectious Diseases Emerging Infectious Diseases, Centers for Disease Control and Prevention, 2013, 19 (10), pp.1703-1705. ⟨10.3201/eid1910.130345⟩ Emerging Infectious Diseases, 2013, 19 (10), pp.1703-1705. ⟨10.3201/eid1910.130345⟩ Emerging Infectious Diseases, Vol 19, Iss 10, Pp 1703-1705 (2013) |
| ISSN: | 1080-6040 1080-6059 |
| DOI: | 10.3201/eid1910.130345⟩ |
| Popis: | To the Editor: We report a case of recurrent Bordetella holmesii bacteremia with 4 clinical manifestations: 3 episodes of cellulitis and 1 episode of pneumonia. The patient, a 67-year-old man, was admitted to the Pitie-Salpetriere hospital in Paris, France, in December 2010, for recurrent cellulitis in his left leg. Eleven years earlier, diffuse large B-cell lymphoma had been diagnosed, and he had undergone 7 chemotherapy courses. He also had received 2 autologous stem cell transplants. He was receiving maintenance treatment with intravenous (IV) rituximab every 3 months and IV immunoglobulin for hypogammaglobulinemia. The first episode of cellulitis had occurred in his left leg 2 months before admission; the condition was treated with pristinamycin (3 g/day for 14 days), and the leg healed completely. Cellulitis recurred in his left leg 2 months later; it was again treated with pristinamycin (3 g/day) for 4 days in conjunction with fusidic acid. The cutaneous lesions worsened, and he was admitted to the hospital with fever (38.6°C) and chills. Clinical examination showed extended cellulitis; the left leg was bright red, hot, shiny, swollen, and non-pitting. The patient’s leukocyte count was 23 × 109/L (reference 1 year of follow-up. B. holmesii was first described in 1995 (2); it was primarily isolated from the blood of immunocompromised patients, especially those with spleen dysfunction. Since 1999, B. holmesii has been detected during pertussis outbreaks in NPS specimens of patients with pertussis-like signs and symptoms (3–6). To our knowledge, the association between B. holmesii infection and rituximab treatment has been reported only once, in a renal transplant recipient, and B. holmesii nasal carriage was not tested for (7). In this patient, the B. holmesii infection relapses definitively stopped after rituximab treatment was interrupted, which suggests a relationship between the 2 events and that patients receiving rituximab are at increased risk for severe infection (8). Interpretations of antimicrobial drug resistance are difficult because no breakpoints have been defined for this species, but MICs of the drugs showed changes in the resistance profile between infectious episodes (Table). These observations strongly suggest a heterogeneous population of bacteria and that resistance was acquired after antimicrobial drug treatment as described in the United Kingdom (9). The patient improved while receiving ceftriaxone, although, in vitro; the bacterium was found resistant to this antimicrobial drug family as reported (10). Thus, the in vitro susceptibility testing and in vivo efficacy were discordant. In conclusion, the patient’s nasal carriage and rituximab treatment may explain the recurrent infection. That the nasal carriage was the primary mode of transmission could not be proven because NPS specimens were not taken early enough. More studies are needed to determine the role of nasal carriage in B. holmesii bacteremia. That no B. holmesii infections occurred after rituximab was stopped suggests that rituximab played a role in the recurrent infections. In cases of recurrent infection or bacteremia, nasal carriage should be assessed, and the interruption of rituximab should be considered by physicians. |
| Databáze: | OpenAIRE |
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