Ayuthaya Satja Issaranggoon Na, Leelaporn Amornrut, Kiratisin Pattarachai, Oberdorfer Peninnah
From the Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai (SInA, PO); and Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand (AL, PK).
Medicine (Baltimore). 2015 May;94(17):e709. doi: 10.1097/MD.0000000000000709.
Pseudoclavibacter has rarely been documented as an etiologic agent of infection in humans. We presented the first case report of Pseudoclavibacter otitis media in a boy with pulmonary and spinal tuberculosis.A 3-year-old boy was referred to our hospital due to prolonged fever and progressive paraplegia for 3 months. He had yellowish discharge from both ear canals. The pleural fluid culture was positive for Mycobacterium tuberculosis. The discharge from both ears culture yielded yellow colonies of gram-positive bacilli with branching. This organism was positive for modified acid-fast bacilli stain but negative for acid-fast bacilli stain. Biochemical characteristics of this isolate were positive for catalase test but negative for oxidase, nitrate, esculin, and sugar utilization tests. The organism was further subjected to be identified by 16S ribosomal deoxyribonucleic acid gene sequencing. The result yielded Pseudoclavibacter species (99.4% identical), which could be most likely a potential pathogen in immunocompromised host like this patient. He responded well with intravenous trimetroprim-sulfamethoxazole for 6 weeks.This is the first case report of Pseudoclavibacter otitis media in children, and this case could emphasize Pseudoclavibacter species as a potential pathogen in immunocompromised host.
假棒状杆菌很少被记录为人类感染的病原体。我们报告了首例假棒状杆菌中耳炎病例，该病例发生在一名患有肺结核和脊柱结核的男孩身上。一名3岁男孩因持续发热和进行性截瘫3个月被转诊至我院。他双侧耳道有淡黄色分泌物。胸腔积液培养结核分枝杆菌呈阳性。双耳分泌物培养产生革兰氏阳性分支杆菌黄色菌落。该菌改良抗酸杆菌染色阳性，但抗酸杆菌染色阴性。该分离株的生化特性过氧化氢酶试验阳性，但氧化酶、硝酸盐、七叶苷和糖利用试验阴性。该菌进一步通过16S核糖体脱氧核糖核酸基因测序进行鉴定。结果显示为假棒状杆菌属（99.4%同源），很可能是像该患者这样免疫功能低下宿主中的潜在病原体。他接受静脉注射甲氧苄啶-磺胺甲恶唑治疗6周后反应良好。这是儿童假棒状杆菌中耳炎的首例病例报告，该病例可强调假棒状杆菌属作为免疫功能低下宿主中潜在病原体的情况。
