gms | German Medical Science

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010)

Deutsche Gesellschaft für Infektiologie,
Deutsche AIDS-Gesellschaft,
Deutsche Gesellschaft für Tropenmedizin und Internationale Gesundheit,
Paul-Ehrlich-Gesellschaft für Chemotherapie

23.06. - 26.06.2010, Köln

Solobacterium moorei septicemia with concomitant mediastinitis in a patient with oesophageal or tracheal carcinoma

Solobacterium moorei Sepsis mit Begleitmediastinitis bei einem Patienten mit Ösophagus- oder Trachealkarzinom

Meeting Abstract

  • A. Mischnik - Universitätsklinikum Heidelberg, Department für Infektiologie, Medizinische Mikrobiologie und Hygiene, Heidelberg, Germany
  • A. Khamooshi-Padiasek - Thoraxklinik am Universitätsklinikum Heidelberg, Abteilung Onkologie/Innere Medizin, Heidelberg, Germany
  • M. Steins - Thoraxklinik am Universitätsklinikum Heidelberg, Abteilung Onkologie/Innere Medizin, Heidelberg, Germany
  • S. Zimmermann - Universitätsklinikum Heidelberg, Department für Infektiologie, Medizinische Mikrobiologie und Hygiene, Heidelberg, Germany

10. Kongress für Infektionskrankheiten und Tropenmedizin (KIT 2010). Köln, 23.-26.06.2010. Düsseldorf: German Medical Science GMS Publishing House; 2010. DocP68

DOI: 10.3205/10kit124, URN: urn:nbn:de:0183-10kit1241

Veröffentlicht: 2. Juni 2010

© 2010 Mischnik et al.
Dieser Artikel ist ein Open Access-Artikel und steht unter den Creative Commons Lizenzbedingungen (http://creativecommons.org/licenses/by-nc-nd/3.0/deed.de). Er darf vervielfältigt, verbreitet und öffentlich zugänglich gemacht werden, vorausgesetzt dass Autor und Quelle genannt werden.


Gliederung

Text

Objectives: Solobacterium with the only species Solobacterium moorei was described first in 2000 as an Eubacterium-like-strain identified by 16S rRNA gene sequence analysis. It was first found in human feces, later in pharyngeal flora. Its pathogenicity is still unclear. Only two cases of septicemia have been published till now.

Results: We report a case of a 59-year-old man who presented with thoracic pain, fever and elevated infection parameters. In the anamnesis he presented a medical history with liver cirrhosis CHILD, regular alcohol consumption, thrombocytopenia, splenomegaly, struma diffusa, hypertension, hypercholesterolemia and gonarthrosis. After exclusion of a cardiac origin of his pain his state of health deteriorated severely. Infection parameters, the patient became septic showing clinical signs of mediastinitis. Empiric treatment with Meropenem 3x500 mg was started. Oesophagogastro-duodenoscopy and bronchoscopy revealed suspicion of malignancy in the trachea or the oesophagus histologically confirmed later. We assume oesophageal lesions as portal of entry for mediastinitis. Another focus of sepsis could not be found. Growth of an anaerobic, Gram-positive, partly pleomorphic short rod was detected after two days of incubation in a BACTEC anaerobic bottle (Becton Dickinson). The isolate was tested biochemically by the Vitek System (bioMérieux), the API rapid ID 32 A system (bioMérieux) without identifying the bacterium. 16S rRNA gene sequence analysis identified the bacterium as Solobacterium moorei showing genetic similarity to Erysipelothrix rhusiopathiae. History of veterinarian or exposure to cattle or animals was not given in our case. The bacterium was found susceptible to Amoxicillin/Clavulanic acid (MIC <0.015 mg/l), Clindamycin (MIC 0.5 mg/l), Imipenem (MIC 0.004 mg/l), Metronidazole (0.015 mg/l), Penicillin G (MIC 0.032 mg/l), Piperacillin/Tazobactam (MIC 0.047 mg/l) and Vancomycin (MIC 0.12 mg/l), but resistant to Clarithromycin. Under treatment following sets of blood cultures remained sterile.

Conclusions: With this report we can underline the pathogenicity of Solobacterium moorei in a significant clinical infectious process. Due to the difficult identification of Eubacterium-like-bacteria assessment of their clinical relevance is difficult.