Verona Julián, Dirialdi Noelia Cecilia, Mutti María Virginia, Scioli Marcelo Carlos, Thougnon Islas Fernando Andrés, Curi Antún Germán Emilio, Sgariglia Lisandro Juan, Homar María Guillermina, Legato José Andrés, Costa Agustina, Maldonado María Laura, Di Conza José A, Litterio Bürki Mirta R
Hospital de Balcarce "Dr Felipe A, Fossati", Argentina.
Hospital de Balcarce "Dr Felipe A, Fossati", Argentina.
Rev Argent Microbiol. 2020 Oct-Dec;52(4):283-287. doi: 10.1016/j.ram.2020.01.001. Epub 2020 Mar 20.
We report the case of a twenty-year-old immunocompetent male patient presenting to the emergency room with pharyngitis and fever. Blood cultures were drawn and Arcanobacterium haemolyticum (rough biotype) was recovered. The presence of the arcanolysin gene was investigated at the molecular level and the upstream region was amplified and sequenced in order to correlate it with the smooth or rough biotype. Although the isolate was susceptible to penicillin, vancomycin and gentamicin, empirical treatments first with amoxicillin/clavulanic acid (1g/12h) and then with ceftriaxone (1g/12h) failed and the infection evolved to sepsis. Finally, treatment with vancomycin (1g/12h) plus piperacillin/tazobactam (4.5g/8h) was effective. Lemierre's syndrome was ruled out. To the best of our knowledge, this is the first case of bacteremia by A. haemolyticum reported in Argentina.
我们报告了一例20岁免疫功能正常的男性患者，因咽炎和发热前往急诊室就诊。采集了血培养样本，培养出了溶血隐秘杆菌（粗糙生物型）。在分子水平上研究了溶血素基因的存在情况，并对上游区域进行了扩增和测序，以便将其与光滑或粗糙生物型相关联。尽管分离株对青霉素、万古霉素和庆大霉素敏感，但先用阿莫西林/克拉维酸（1g/12小时）然后用头孢曲松（1g/12小时）进行的经验性治疗均失败，感染发展为败血症。最后，使用万古霉素（1g/12小时）加哌拉西林/他唑巴坦（4.5g/8小时）治疗有效。排除了勒米尔综合征。据我们所知，这是阿根廷报道的首例由溶血隐秘杆菌引起的菌血症病例。
