Achromobacter xylosoxidans/denitrificans bacteremia and subsequent fatal Escherichia coli/Streptococcus anginosus pleural empyema
Achromobacter xylosoxidans, a gram-negative bacillus with low virulence has rarely been reported to cause clinically significant infections. We report an unusual case of MDR Achromobacter xylosoxidans/denitrificans bacteremia from a peripherally inserted central catheter (PICC) and subsequent fatal...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Elsevier
2018-01-01
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| Series: | Respiratory Medicine Case Reports |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2213007118302545 |
| _version_ | 1828346391271833600 |
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| author | Saad Habib Nicholas Fuca Mohammed Azam Abdul Hasan Siddiqui Kartikeya Rajdev Michel Chalhoub |
| author_facet | Saad Habib Nicholas Fuca Mohammed Azam Abdul Hasan Siddiqui Kartikeya Rajdev Michel Chalhoub |
| author_sort | Saad Habib |
| collection | DOAJ |
| description | Achromobacter xylosoxidans, a gram-negative bacillus with low virulence has rarely been reported to cause clinically significant infections. We report an unusual case of MDR Achromobacter xylosoxidans/denitrificans bacteremia from a peripherally inserted central catheter (PICC) and subsequent fatal pleural empyema due to MDR Escherichia coli and Streptococcus anginosus. A 44-year-old male presented to the hospital with chief complaints of chest tightness associated with a productive cough. He was found to have pleural empyema secondary to MDR E. coli and S. anginous. Three months prior to current presentation, he had a history of MDR A. xylosoxidans originating from a PICC. The patient expired even after appropriate management. Thoracic empyema continues to cause significant morbidity and mortality despite the improvement of antimicrobial therapy and the existence of multiple options for drainage of the infected pleural space. The bacteriology of thoracic empyema has been changing since the introduction of antibiotics. Typical antibiotics used to treat these MDR pathogens have become obsolete. Therefore, physicians should be aggressive in their diagnostic approach to pleural empyema, since the isolation of MDR aerobic gram-negative bacilli or multiple pathogens from the pleural fluid is associated with a poor prognosis and indicates a need for more aggressive antimicrobial chemotherapy. Also, the association of indwelling medical devices and MDR Achromobacter bacteremia should be known. |
| first_indexed | 2024-04-14T00:25:21Z |
| format | Article |
| id | doaj.art-210afbf5ade743b1bd01c90d701ae06e |
| institution | Directory Open Access Journal |
| issn | 2213-0071 |
| language | English |
| last_indexed | 2024-04-14T00:25:21Z |
| publishDate | 2018-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Respiratory Medicine Case Reports |
| spelling | doaj.art-210afbf5ade743b1bd01c90d701ae06e2022-12-22T02:22:45ZengElsevierRespiratory Medicine Case Reports2213-00712018-01-0125311313Achromobacter xylosoxidans/denitrificans bacteremia and subsequent fatal Escherichia coli/Streptococcus anginosus pleural empyemaSaad Habib0Nicholas Fuca1Mohammed Azam2Abdul Hasan Siddiqui3Kartikeya Rajdev4Michel Chalhoub5Department of Internal Medicine, Northwell Health, Staten Island University Hospital, USA; Corresponding author.Department of Internal Medicine, Northwell Health, Staten Island University Hospital, USADepartment of Internal Medicine, Northwell Health, Staten Island University Hospital, USADepartment of pulmonary and critical care, Northwell health, Staten Island University Hospital, USADepartment of Internal Medicine, Northwell Health, Staten Island University Hospital, USADepartment of pulmonary and critical care, Northwell health, Staten Island University Hospital, USAAchromobacter xylosoxidans, a gram-negative bacillus with low virulence has rarely been reported to cause clinically significant infections. We report an unusual case of MDR Achromobacter xylosoxidans/denitrificans bacteremia from a peripherally inserted central catheter (PICC) and subsequent fatal pleural empyema due to MDR Escherichia coli and Streptococcus anginosus. A 44-year-old male presented to the hospital with chief complaints of chest tightness associated with a productive cough. He was found to have pleural empyema secondary to MDR E. coli and S. anginous. Three months prior to current presentation, he had a history of MDR A. xylosoxidans originating from a PICC. The patient expired even after appropriate management. Thoracic empyema continues to cause significant morbidity and mortality despite the improvement of antimicrobial therapy and the existence of multiple options for drainage of the infected pleural space. The bacteriology of thoracic empyema has been changing since the introduction of antibiotics. Typical antibiotics used to treat these MDR pathogens have become obsolete. Therefore, physicians should be aggressive in their diagnostic approach to pleural empyema, since the isolation of MDR aerobic gram-negative bacilli or multiple pathogens from the pleural fluid is associated with a poor prognosis and indicates a need for more aggressive antimicrobial chemotherapy. Also, the association of indwelling medical devices and MDR Achromobacter bacteremia should be known.http://www.sciencedirect.com/science/article/pii/S2213007118302545 |
| spellingShingle | Saad Habib Nicholas Fuca Mohammed Azam Abdul Hasan Siddiqui Kartikeya Rajdev Michel Chalhoub Achromobacter xylosoxidans/denitrificans bacteremia and subsequent fatal Escherichia coli/Streptococcus anginosus pleural empyema Respiratory Medicine Case Reports |
| title | Achromobacter xylosoxidans/denitrificans bacteremia and subsequent fatal Escherichia coli/Streptococcus anginosus pleural empyema |
| title_full | Achromobacter xylosoxidans/denitrificans bacteremia and subsequent fatal Escherichia coli/Streptococcus anginosus pleural empyema |
| title_fullStr | Achromobacter xylosoxidans/denitrificans bacteremia and subsequent fatal Escherichia coli/Streptococcus anginosus pleural empyema |
| title_full_unstemmed | Achromobacter xylosoxidans/denitrificans bacteremia and subsequent fatal Escherichia coli/Streptococcus anginosus pleural empyema |
| title_short | Achromobacter xylosoxidans/denitrificans bacteremia and subsequent fatal Escherichia coli/Streptococcus anginosus pleural empyema |
| title_sort | achromobacter xylosoxidans denitrificans bacteremia and subsequent fatal escherichia coli streptococcus anginosus pleural empyema |
| url | http://www.sciencedirect.com/science/article/pii/S2213007118302545 |
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