Abuquteish Dua, AlNawawi Daifallah, Khorvash Reza, Ata Osama M Abu, Almasri Nidal
Department of Microbiology, Pathology and Forensic Medicine, Faculty of Medicine, The Hashemite University, Zarqa 13133, Jordan.
Department of Pathology and Laboratory Medicine, King Hussein Cancer Center, Amman 11941, Jordan.
Pathogens. 2025 Sep 16;14(9):931. doi: 10.3390/pathogens14090931.
is a bacterium predominantly reported in the stomach and associated with emphysematous gastritis, delayed gastric emptying, gastroparesis, or gastric outlet obstruction. Its prevalence is increasing among patients with a history of organ transplants, immunosuppression, and graft-versus-host disease (GVHD). This bacterium can be detected on histology with characteristic tetrad packet morphology; however, confirmation requires PCR and molecular studies. The role of in human diseases is not fully understood and has unclear clinical significance. While certain studies point to a possible pathogenic role, others regard its detection as incidental with no clear clinical consequence.
Herein, we report a case of a 39-year-old male patient with primary refractory cHL, stage IVb, who underwent an autologous bone marrow transplant (BMT) and an allogeneic stem cell infusion. His post-transplant course was complicated by chronic kidney disease (CKD), malnutrition, depression, myopathy, skin, and colon GVHD. He eventually developed sepsis, was admitted to the ICU and developed multiorgan failure and passed away. The patient developed diarrhea, and the gastrointestinal specialist was consulted and revealed ulcerated ileitis and colitis. Biopsies were taken to evaluate for CMV infection and GVHD. The terminal ileum biopsy mainly revealed ulceration with granulation tissue formation and abundant microorganisms arranged in distinctive tetrads, characteristic of . The colonic biopsies were consistent with GVHD grade II.
The significance of Sarcina microorganisms and their mechanisms of injury remain poorly understood. The identification of in the terminal ileum, which is an unusual and previously unreported finding, adds a new perspective to our understanding of its pathogenic potential and anatomical distribution. While the patient's clinical decline was influenced by multiple factors, including GVHD, recurrent sepsis, and multiorgan failure, the role of as a potential exacerbating factor remains unclear.
是一种主要在胃中被报道的细菌，与气肿性胃炎、胃排空延迟、胃轻瘫或胃出口梗阻有关。在有器官移植、免疫抑制和移植物抗宿主病（GVHD）病史的患者中，其患病率正在上升。这种细菌可通过组织学检测到，具有特征性的四联包囊形态；然而，确诊需要PCR和分子研究。在人类疾病中的作用尚未完全了解，临床意义尚不清楚。虽然某些研究指出其可能具有致病作用，但其他研究则认为其检测为偶然发现，没有明确的临床后果。
在此，我们报告一例39岁的男性原发性难治性cHL患者，IVb期，接受了自体骨髓移植（BMT）和异基因干细胞输注。他的移植后病程并发慢性肾病（CKD）、营养不良、抑郁症、肌病、皮肤和结肠GVHD。他最终发展为败血症，被收入重症监护病房，出现多器官功能衰竭并去世。患者出现腹泻，咨询胃肠病专家后发现溃疡性回肠炎和结肠炎。进行活检以评估巨细胞病毒感染和GVHD。回肠末端活检主要显示溃疡形成，伴有肉芽组织形成，并有大量以独特四联形式排列的微生物，具有的特征。结肠活检符合II级GVHD。
八叠球菌微生物的意义及其损伤机制仍了解甚少。在回肠末端发现，这是一个不寻常且以前未报道过的发现，为我们理解其致病潜力和解剖分布增添了新的视角。虽然患者的临床病情恶化受多种因素影响，包括GVHD、复发性败血症和多器官功能衰竭，但作为潜在加重因素的作用仍不清楚。
