Department of Laboratory Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Jiefang Road 1095#, Wuhan, 430030, China.
BMC Infect Dis. 2018 Dec 14;18(1):661. doi: 10.1186/s12879-018-3495-9.
Leptotrichia species are aerotolerant, Gram-negative fusiform bacteria. Cases of bacteremia caused by Leptotrichia trevisanii in immunocompromised patients have been rarely reported.
A 33-year-old female with systemic lupus erythematosus (SLE) was admitted to the department of rheumatology with bleeding from a mucosal ulcer. One month previously, she had visited our hospital and begun to receive methotrexate therapy, but mis-dosed for nearly 1 month at home. Methotrexate toxicity resulted in a severe oral ulcer and bone marrow suppression. On day-7 of hospital admission, she developed a fever, and Gram-negative rods (Leptotrichia trevisanii) were detected in blood cultures. She was diagnosed with methotrexate poisoning followed by L. trevisanii bacteremia. After antibiotic and detoxification therapy, she recovered from bacteremia, and the oral ulcer and bone-marrow suppression improved obviously.
This is the first reported case of Leptotrichia trevisanii bacteremia in a SLE patient who took mis-dosed an immunosuppressant and had an oral mucosal lesion.
纤毛菌属是兼性需氧、革兰阴性梭形细菌。免疫功能低下患者感染纤毛菌属（尤其是特氏纤毛菌）引起菌血症的情况罕见。
一名 33 岁女性，患有系统性红斑狼疮（SLE），因黏膜溃疡出血被收入风湿科。1 个月前，她曾来我院就诊并开始接受甲氨蝶呤治疗，但在家中误服近 1 个月。甲氨蝶呤中毒导致严重口腔溃疡和骨髓抑制。入院第 7 天，她开始发热，血培养检出革兰阴性杆菌（特氏纤毛菌）。诊断为甲氨蝶呤中毒继发特氏纤毛菌菌血症。经抗生素和解毒治疗后，患者菌血症得到控制，口腔溃疡和骨髓抑制明显改善。
这是首例报道的 SLE 患者因误服免疫抑制剂且存在口腔黏膜损伤而发生特氏纤毛菌菌血症的病例。
