Kobayashi A, Mori K, Konishi M, Maeda K, Mikasa K, Yoneda T, Narita N, Sano R, Masutani T
Second Department of Internal Medicine, Nara Medical University.
Kansenshogaku Zasshi. 1998 Oct;72(10):1070-5. doi: 10.11150/kansenshogakuzasshi1970.72.1070.
Achromobacter xylosoxidans is a gram-negative bacterium whose natural habitat has not been clearly defined. It has been isolated from ear discharge and the large intestine of humans and from various hospital or environmental water sources. Infection with A. xylosoxidans in humans has been documented, and resulting illnesses include meningitis, pneumonia, cholecystitis, peritonitis and urinary tract infection. Bacteremia due to A. xylosoxidans is rare, and little information on treatment is available. Two cases of bacteremia due to A. xylosoxidans in patients with hemapoietic malignancies are reported herein. Case 1 involved a 70-yr. male whose clinical diagnosis was IgA lambda-type plasmacytoma. Case 2 involved 72-yr. male whose clinical diagnosis was acute lymphatic leukemia (L2). Both patients had been catheterized. Neutropenia was noted and the white blood cell counts were 20/microliter in case 1 and 35/microliter in case 2 when A. xylosoxidans was isolated from the blood culture. We suggest that bacteremia due to A. xylosoxidans may have been related to the presence of the catheter and neutropenia.
木糖氧化无色杆菌是一种革兰氏阴性菌,其天然栖息地尚未明确界定。它已从人类的耳分泌物和大肠以及各种医院或环境水源中分离出来。人类感染木糖氧化无色杆菌的情况已有记录,由此导致的疾病包括脑膜炎、肺炎、胆囊炎、腹膜炎和尿路感染。木糖氧化无色杆菌引起的菌血症很少见,关于治疗的信息也很少。本文报告了两例造血系统恶性肿瘤患者因木糖氧化无色杆菌引起菌血症的病例。病例1为一名70岁男性,临床诊断为IgA λ型浆细胞瘤。病例2为一名72岁男性,临床诊断为急性淋巴细胞白血病(L2)。两名患者均已插管。从血培养中分离出木糖氧化无色杆菌时,两名患者均出现中性粒细胞减少,病例1的白细胞计数为20/微升,病例2为35/微升。我们认为,木糖氧化无色杆菌引起的菌血症可能与插管和中性粒细胞减少有关。