Moktan Varun, Elwasila Sammer, Umadat Goyal, Hata D Jane, Meza Diana, Patel Robin, Libertin Claudia, Brumble Lisa
Department of Community Internal Medicine, Mayo Clinic, Jacksonville, FL, USA.
Department of Infectious Disease, Mayo Clinic, Jacksonville, FL, USA.
IDCases. 2021 Nov 16;26:e01339. doi: 10.1016/j.idcr.2021.e01339. eCollection 2021.
The species are Gram positive, coryneform bacteria that belong to the Actinobacteria phylum and have been linked to bacteremia in immunocompromised children. We present the first documented adult case of bacteremia. The patient was a 52-year-old woman with a history of recurrent infection, sinus tachycardia and high-risk AML who had been admitted one month prior to presentation for matched unrelated donor hematopoietic stem cell transplant with reduced intensity fludarabine-melphalan. Thirty days post-transplant, the infectious disease team was consulted because blood cultures grew , from one of two blood cultures It took nine days to identify the species. She was treated with linezolid and imipenem. are rarely implicated in human pathology, and therein, usually identified in the context of malignancy and relative immunosuppression. was only previously reported from the bloodstream of a previously healthy 8-week-old infant without underlying medical conditions. Antimicrobial susceptibility testing is challenging as only in vitro susceptibility testing of has been reported. Given these challenges, it is our hope to illustrate the clinical approach to diagnosis as well as subsequent recommendations for treatment in a particularly challenging case of bacteremia in an AML patient.
这些菌种为革兰氏阳性、棒状杆菌属细菌，属于放线菌门，与免疫功能低下儿童的菌血症有关。我们报告了首例有记录的成人菌血症病例。患者为一名52岁女性，有反复感染、窦性心动过速病史以及高危急性髓系白血病（AML），在此次就诊前一个月因接受氟达拉滨-马法兰减低剂量预处理的匹配无关供者造血干细胞移植而入院。移植后30天，因两份血培养中有一份培养出该菌种，感染病团队会诊。鉴定该菌种花了9天时间。她接受了利奈唑胺和亚胺培南治疗。该菌种很少与人类病理学相关，而且通常是在恶性肿瘤和相对免疫抑制的背景下被鉴定出来。此前仅报道过一例来自一名无基础疾病的健康8周龄婴儿血液中的该菌种。抗菌药敏试验具有挑战性，因为仅报道过该菌种的体外药敏试验。鉴于这些挑战，我们希望阐述在一名AML患者菌血症这一特别具有挑战性的病例中诊断的临床方法以及后续的治疗建议。
