Lachnoanaerobaculum orale bacteremia in a patient with acute myeloid leukemia and stomatitis: An emerging pathogen
Background: Lachnoanaerobaculum orale is a newly described, obligately anaerobic gram-positive bacillus. The first report of invasive disease caused by L. orale was described in a patient with acute lymphocytic leukemia following systematic chemotherapy. Here we describe another case of L. orale bac...
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| Format: | Article |
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Elsevier
2023-01-01
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| Series: | IDCases |
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| Online Access: | http://www.sciencedirect.com/science/article/pii/S2214250923001610 |
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| author | Nasruddin Ali Salad Sabrie Sheliza Halani Finlay Maguire Patryk Aftanas Robert Kozak Nisha Andany |
| author_facet | Nasruddin Ali Salad Sabrie Sheliza Halani Finlay Maguire Patryk Aftanas Robert Kozak Nisha Andany |
| author_sort | Nasruddin Ali Salad Sabrie |
| collection | DOAJ |
| description | Background: Lachnoanaerobaculum orale is a newly described, obligately anaerobic gram-positive bacillus. The first report of invasive disease caused by L. orale was described in a patient with acute lymphocytic leukemia following systematic chemotherapy. Here we describe another case of L. orale bacteremia in a patient with a hematologic malignancy following chemotherapy-induced neutropenia. Methods: We present a case of a 46-year-old woman with a recent diagnosis of AML who presented to Sunnybrook Health Sciences Center with febrile neutropenia following induction chemotherapy with daunorubicin-cytarabine (3 +7 regimen) with Gemtuzumab and Ozogamycin. Despite being on intravenous pipercillin-tazobactam she remained febrile. Following our clinical assessment and investigations, potential sources of infection included a swollen digit and severe mucositis. Results: One blood culture from admission grew Lachnoanaerobaculum orale in the anaerobic bottle, identified by Matrix-Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF). The isolate also underwent whole-genome sequencing using methods that have been described previously. Results demonstrated the organism was susceptible to cefoxitin, clindamycin, meropenem, metronidazole, penicillin, and piperacillin-tazobactam. We concluded that the source of this patient’s bloodstream infection to be chemotherapy-induced stomatitis. Conclusion: With the increasing use of intensive immunosuppressive regimens and hematopoietic stem cell transplantation for patients with hematologic malignancies, there has been an increase in the incidence and detection of bloodstream infections due to anaerobic organisms. This is only the second case report of L. orale bacteremia, highlighting its emerging role as an opportunistic pathogen in immunocompromised patients. |
| first_indexed | 2024-03-12T02:22:25Z |
| format | Article |
| id | doaj.art-b3e36ef111d14b16ab0bbf6354dfa7a7 |
| institution | Directory Open Access Journal |
| issn | 2214-2509 |
| language | English |
| last_indexed | 2024-03-12T02:22:25Z |
| publishDate | 2023-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | IDCases |
| spelling | doaj.art-b3e36ef111d14b16ab0bbf6354dfa7a72023-09-06T04:51:15ZengElsevierIDCases2214-25092023-01-0133e01837Lachnoanaerobaculum orale bacteremia in a patient with acute myeloid leukemia and stomatitis: An emerging pathogenNasruddin Ali Salad Sabrie0Sheliza Halani1Finlay Maguire2Patryk Aftanas3Robert Kozak4Nisha Andany5Department of Medicine, University of Toronto, CanadaDepartment of Medicine, University of Toronto, CanadaShared Hospital Laboratory, CanadaShared Hospital Laboratory, CanadaShared Hospital Laboratory, Canada; Department of Laboratory Medicine & Pathology, Sunnybrook Health Sciences Centre, CanadaDepartment of Medicine, University of Toronto, Canada; Division of Infectious Diseases, Sunnybrook Health Sciences Centre, Canada; Correspondence to: Division of Infectious Diseases, Sunnybrook Health Sciences Centre, 2075 Bayview Ave., Room E209, Toronto, ON M4N 3M5, Canada.Background: Lachnoanaerobaculum orale is a newly described, obligately anaerobic gram-positive bacillus. The first report of invasive disease caused by L. orale was described in a patient with acute lymphocytic leukemia following systematic chemotherapy. Here we describe another case of L. orale bacteremia in a patient with a hematologic malignancy following chemotherapy-induced neutropenia. Methods: We present a case of a 46-year-old woman with a recent diagnosis of AML who presented to Sunnybrook Health Sciences Center with febrile neutropenia following induction chemotherapy with daunorubicin-cytarabine (3 +7 regimen) with Gemtuzumab and Ozogamycin. Despite being on intravenous pipercillin-tazobactam she remained febrile. Following our clinical assessment and investigations, potential sources of infection included a swollen digit and severe mucositis. Results: One blood culture from admission grew Lachnoanaerobaculum orale in the anaerobic bottle, identified by Matrix-Assisted Laser Desorption Ionization-Time of Flight (MALDI-TOF). The isolate also underwent whole-genome sequencing using methods that have been described previously. Results demonstrated the organism was susceptible to cefoxitin, clindamycin, meropenem, metronidazole, penicillin, and piperacillin-tazobactam. We concluded that the source of this patient’s bloodstream infection to be chemotherapy-induced stomatitis. Conclusion: With the increasing use of intensive immunosuppressive regimens and hematopoietic stem cell transplantation for patients with hematologic malignancies, there has been an increase in the incidence and detection of bloodstream infections due to anaerobic organisms. This is only the second case report of L. orale bacteremia, highlighting its emerging role as an opportunistic pathogen in immunocompromised patients.http://www.sciencedirect.com/science/article/pii/S2214250923001610AnaerobesStomatitisFebrile neutropenia |
| spellingShingle | Nasruddin Ali Salad Sabrie Sheliza Halani Finlay Maguire Patryk Aftanas Robert Kozak Nisha Andany Lachnoanaerobaculum orale bacteremia in a patient with acute myeloid leukemia and stomatitis: An emerging pathogen IDCases Anaerobes Stomatitis Febrile neutropenia |
| title | Lachnoanaerobaculum orale bacteremia in a patient with acute myeloid leukemia and stomatitis: An emerging pathogen |
| title_full | Lachnoanaerobaculum orale bacteremia in a patient with acute myeloid leukemia and stomatitis: An emerging pathogen |
| title_fullStr | Lachnoanaerobaculum orale bacteremia in a patient with acute myeloid leukemia and stomatitis: An emerging pathogen |
| title_full_unstemmed | Lachnoanaerobaculum orale bacteremia in a patient with acute myeloid leukemia and stomatitis: An emerging pathogen |
| title_short | Lachnoanaerobaculum orale bacteremia in a patient with acute myeloid leukemia and stomatitis: An emerging pathogen |
| title_sort | lachnoanaerobaculum orale bacteremia in a patient with acute myeloid leukemia and stomatitis an emerging pathogen |
| topic | Anaerobes Stomatitis Febrile neutropenia |
| url | http://www.sciencedirect.com/science/article/pii/S2214250923001610 |
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