infection after haematopoietic cell transplantation: not just a plant pathogen?

INTRODUCTION

spp. have been implicated in a variety of infections in immunocompromised and immunocompetent hosts. is responsible for the majority of reported cases, but , and infections have been described. There are no prior reports of human infection with .

CASE PRESENTATION

We describe the unexpected finding of in liver lesions incidentally noted at autopsy in an immunosuppressed patient status after bone-marrow transplant for acute lymphoblastic leukaemia who died of unrelated causes (septic shock due to colitis). At autopsy, an otherwise unremarkable liver contained several dozen well-demarcated sclerotic-appearing lesions measuring 0.1-0.3 cm in size. The absence of other bacterial or fungal DNA in the setting of histologically visible organisms argues against its presence as a contaminant and raises the consideration that represents a human pathogen for the immunocompromised.

CONCLUSION

Whether it represents the sole infectious agent responsible for the miliary lesions or a partially treated co-infection is impossible to determine, but our finding continues to reinforce the importance of molecular techniques in associating organisms with sites of infection and optimizing treatment of infectious diseases.