Mesenteric abscess caused by coinfection with Bacillus Calmette-Guérin and Phialemonium sp. in chronic granulomatous disease
Opportunistic infections are life-threatening conditions in immunocompromised patients including those with primary immunodeficiency. We describe a case of X-linked chronic granulomatous disease presenting with mesenteric abscess caused by a coinfection with Bacillus Calmette-Guérin (BCG) and Phiale...
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| Format: | Article |
| Language: | English |
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Elsevier
2022-01-01
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| Series: | IDCases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214250922000038 |
| _version_ | 1831809763758833664 |
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| author | Hanae Miyazawa Yusuke Matsuda Seisho Sakai Katsuhiko Kamei Taizo Wada |
| author_facet | Hanae Miyazawa Yusuke Matsuda Seisho Sakai Katsuhiko Kamei Taizo Wada |
| author_sort | Hanae Miyazawa |
| collection | DOAJ |
| description | Opportunistic infections are life-threatening conditions in immunocompromised patients including those with primary immunodeficiency. We describe a case of X-linked chronic granulomatous disease presenting with mesenteric abscess caused by a coinfection with Bacillus Calmette-Guérin (BCG) and Phialemonium sp. The patient received BCG vaccination at 5 months old. He developed left axillary BCG lymphadenitis at 17 months of age, and 3 months later mesenteric abscess occurred. Concomitant use of rifampicin and itraconazole at 17 months of age might have reduced serum itraconazole concentrations and led to superinfection with Phialemonium sp. in our patient, which was susceptible to itraconazole and voriconazole in vitro. The patient was successfully treated with a combination of isoniazid, rifampicin, streptomycin, ciprofloxacin, prednisolone, interferon-γ, and an increased dose of itraconazole, followed by hematopoietic stem cell transplantation. Our results suggest that clinician need to be aware of rifampicin drug interactions, and that precise detection and identification of pathogens are essential to appropriate treatment. |
| first_indexed | 2024-12-22T20:46:08Z |
| format | Article |
| id | doaj.art-551c7a5fdb3a4dab90288563337202ff |
| institution | Directory Open Access Journal |
| issn | 2214-2509 |
| language | English |
| last_indexed | 2024-12-22T20:46:08Z |
| publishDate | 2022-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj.art-551c7a5fdb3a4dab90288563337202ff2022-12-21T18:13:12ZengElsevierIDCases2214-25092022-01-0127e01375Mesenteric abscess caused by coinfection with Bacillus Calmette-Guérin and Phialemonium sp. in chronic granulomatous diseaseHanae Miyazawa0Yusuke Matsuda1Seisho Sakai2Katsuhiko Kamei3Taizo Wada4Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, Japan; Corresponding author.Department of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, JapanDepartment of Pediatric Surgery, Kanazawa University Hospital, 13-1 Takaramachi, Kanazawa 920-8641, JapanMedical Mycology Research Center, Chiba University, 1-8-1 Inohana, Chuo-ku, Chiba 260-8673, JapanDepartment of Pediatrics, School of Medicine, Institute of Medical, Pharmaceutical and Health Sciences, Kanazawa University, 13-1 Takaramachi, Kanazawa 920-8641, JapanOpportunistic infections are life-threatening conditions in immunocompromised patients including those with primary immunodeficiency. We describe a case of X-linked chronic granulomatous disease presenting with mesenteric abscess caused by a coinfection with Bacillus Calmette-Guérin (BCG) and Phialemonium sp. The patient received BCG vaccination at 5 months old. He developed left axillary BCG lymphadenitis at 17 months of age, and 3 months later mesenteric abscess occurred. Concomitant use of rifampicin and itraconazole at 17 months of age might have reduced serum itraconazole concentrations and led to superinfection with Phialemonium sp. in our patient, which was susceptible to itraconazole and voriconazole in vitro. The patient was successfully treated with a combination of isoniazid, rifampicin, streptomycin, ciprofloxacin, prednisolone, interferon-γ, and an increased dose of itraconazole, followed by hematopoietic stem cell transplantation. Our results suggest that clinician need to be aware of rifampicin drug interactions, and that precise detection and identification of pathogens are essential to appropriate treatment.http://www.sciencedirect.com/science/article/pii/S2214250922000038Bacillus Calmette-GuérinChronic granulomatous diseaseCoinfectionMesenteric abscessPhialemonium |
| spellingShingle | Hanae Miyazawa Yusuke Matsuda Seisho Sakai Katsuhiko Kamei Taizo Wada Mesenteric abscess caused by coinfection with Bacillus Calmette-Guérin and Phialemonium sp. in chronic granulomatous disease IDCases Bacillus Calmette-Guérin Chronic granulomatous disease Coinfection Mesenteric abscess Phialemonium |
| title | Mesenteric abscess caused by coinfection with Bacillus Calmette-Guérin and Phialemonium sp. in chronic granulomatous disease |
| title_full | Mesenteric abscess caused by coinfection with Bacillus Calmette-Guérin and Phialemonium sp. in chronic granulomatous disease |
| title_fullStr | Mesenteric abscess caused by coinfection with Bacillus Calmette-Guérin and Phialemonium sp. in chronic granulomatous disease |
| title_full_unstemmed | Mesenteric abscess caused by coinfection with Bacillus Calmette-Guérin and Phialemonium sp. in chronic granulomatous disease |
| title_short | Mesenteric abscess caused by coinfection with Bacillus Calmette-Guérin and Phialemonium sp. in chronic granulomatous disease |
| title_sort | mesenteric abscess caused by coinfection with bacillus calmette guerin and phialemonium sp in chronic granulomatous disease |
| topic | Bacillus Calmette-Guérin Chronic granulomatous disease Coinfection Mesenteric abscess Phialemonium |
| url | http://www.sciencedirect.com/science/article/pii/S2214250922000038 |
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