Asai Nobuhiro, Koizumi Yusuke, Yamada Atsuko, Sakanashi Daisuke, Watanabe Hiroki, Kato Hideo, Shiota Arufumi, Hagihara Mao, Suematsu Hiroyuki, Yamagishi Yuka, Mikamo Hiroshige
Department of Clinical Infectious Diseases, Aichi Medical University Hospital, 〒480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.
Department of Infection Control and Prevention, Aichi Medical University Hospital, Nagakute, Aichi, Japan.
J Med Case Rep. 2019 Feb 13;13(1):33. doi: 10.1186/s13256-019-1969-z.
Pantoea is a Gram-negative, non-encapsulated, non-spore-forming, ubiquitous straight rod which can be isolated from geographical and ecological sources such as plant surfaces, buckwheat seeds, human feces, and the environment. The genus Pantoea is a rare pathogen in a clinical setting, and is divided into 20 different species such as Pantoea agglomerans, Pantoea ananatis, Pantoea deleyi, Pantoea dispersa, Pantoea septica, Pantoea stewartii or Pantoea rwandensis. Pantoea dispersa has been reported to cause other infections, including respiratory infections, neonatal sepsis, and bloodstream infections. We report a case of Pantoea dispersa bacteremia caused by acute cholangitis. This is the first case report of Pantoea dispersa bacteremia caused by acute cholangitis as far as we had searched.
A 38-year-old Japanese woman suffered from acute cholangitis; a blood culture showed that Gram-negative rod was positive. The treatment was successful with intravenously administered meropenem, and it was switched to orally administered levofloxacin according to microbiological susceptibility. The organism was identified as Pantoea dispersa by both genetic investigation by 16S ribosomal RNA and additional biochemical tests. To the best of our knowledge, this is the first case report of Pantoea dispersa bacteremia caused by acute cholangitis.
The epidemiology and clinical features of Pantoea dispersa are still unknown. More cases of infections caused by Pantoea dispersa might be revealed with advancing technical methods, such as matrix-assisted laser desorption/ionization time-of-flight mass spectrometry or 16S ribosomal RNA analysis. Physicians must know that a variety of infections caused by Pantoea dispersa could occur in immunocompromised as well as immunocompetent patients.
泛菌属是一种革兰氏阴性、无荚膜、不形成芽孢、广泛存在的直杆菌，可从植物表面、荞麦种子、人类粪便及环境等地理和生态来源中分离得到。泛菌属在临床环境中是一种罕见的病原体，分为20个不同的种，如成团泛菌、菠萝泛菌、德氏泛菌、分散泛菌、败血泛菌、斯氏泛菌或卢旺达泛菌。据报道，分散泛菌可引起其他感染，包括呼吸道感染、新生儿败血症和血流感染。我们报告一例由急性胆管炎引起的分散泛菌血症病例。据我们检索，这是首例关于急性胆管炎引起分散泛菌血症的病例报告。
一名38岁的日本女性患有急性胆管炎；血培养显示革兰氏阴性杆菌呈阳性。静脉注射美罗培南治疗成功，并根据微生物药敏结果换用口服左氧氟沙星。通过16S核糖体RNA基因检测及其他生化试验，该菌株被鉴定为分散泛菌。据我们所知，这是首例关于急性胆管炎引起分散泛菌血症的病例报告。
分散泛菌的流行病学和临床特征仍不清楚。随着技术方法的进步，如基质辅助激光解吸/电离飞行时间质谱或16S核糖体RNA分析，可能会发现更多由分散泛菌引起的感染病例。医生必须了解，分散泛菌可在免疫功能低下和免疫功能正常的患者中引起多种感染。
