Gonzales Zamora Jose A, Romero Alvarez Maria, Henry Zachary, Baracco Gio J, Dickinson Gordon, Lichtenberger Paola
Department of Medicine, Division of Infectious Diseases, University of Miami Miller School of Medicine, Miami, FL, 33136, United States.
The AIDS Healthcare Foundation, Northpoint Health Center, Fort Lauderdale, FL, 33308, United States.
IDCases. 2020 Feb 28;20:e00734. doi: 10.1016/j.idcr.2020.e00734. eCollection 2020.
is a recently described anaerobic and partially acid-fast bacterium within the order . It is a fastidious microorganism that has been identified as part of the oral microbiota and is rarely associated with human infections. We describe the case of a 70-year-old man with a history of rheumatoid arthritis that developed liver abscesses and pylephlebitis. Gram stain of purulent material obtained by percutaneous drainage of the hepatic collection revealed gram-positive bacilli that stained acid-fast by the Kinyoun method. The patient was initially treated with imipenem, moxifloxacin and clarithromycin for possible and/or nontuberculous mycobacterial infection. Cultures failed to grow the organism seen on the stains, and broad-spectrum 16S rRNA PCR gene sequencing analysis identified it as . Treatment was de-escalated to amoxicillin/clavulanic acid. The hepatic abscesses resolved completely after 4 weeks of treatment. There are only 8 documented cases of human infection caused by reported in the literature. Conventional microbiological methods do not reliably detect this bacterium, and the diagnosis relies on molecular methods. Excellent outcomes are obtained with a combined treatment approach that includes abscess drainage and prolonged antibiotic therapy.
是最近描述的属于该目的一种厌氧且部分抗酸的细菌。它是一种苛求性微生物，已被确定为口腔微生物群的一部分，很少与人类感染相关。我们描述了一名70岁男性的病例，他有类风湿关节炎病史，并发肝脓肿和门静脉炎。经皮引流肝脏积液获得的脓性物质革兰氏染色显示革兰氏阳性杆菌，用金扬法染色呈抗酸性。患者最初接受亚胺培南、莫西沙星和克拉霉素治疗，以应对可能的 和/或非结核分枝杆菌感染。培养未能培养出染色所见的微生物，广谱16S rRNA PCR基因测序分析将其鉴定为 。治疗降级为阿莫西林/克拉维酸。治疗4周后肝脓肿完全消退。文献中仅报道了8例由 引起的人类感染病例。传统微生物学方法不能可靠地检测到这种细菌，诊断依赖于分子方法。采用包括脓肿引流和延长抗生素治疗的联合治疗方法可取得良好效果。
