Clinical and bacteriologic features and clinical outcomes of culture-confirmed campylobacter bacteremia in 21 patients (including nine human immunodeficiency virus [HIV]-infected subjects and 12 non-HIV-infected subjects) were retrospectively evaluated and compared. This study highlights differences between HIV-infected and non-HIV-infected individuals. Campylobacter jejuni bacteremia in HIV-infected patients was found to often be a severe, debilitating febrile illness requiring multiple and prolonged courses of antibiotic therapy. Extraintestinal features, particularly pulmonary involvement, were often observed. Cellulitis occurred in one patient. By contrast, in non-HIV-infected patients, the illness was generally an acute onset of fever associated with self-limiting enteritis, with fever resolving rapidly with antibiotic treatment. Travel history (42% of cases) appeared to be a common risk factor in the latter group. Two of these patients had cutaneous manifestations, thus suggesting that some strains may be more invasive. This study suggests that campylobacter bacteremia is an important cause of morbidity and mortality in HIV-infected individuals; the overall mortality rate among HIV-infected patients with bacteremia in this study was 33%. This is not the case for immunocompetent patients, in whom death rarely occurs.
A fastidious, slowly growing, spiral gram-negative bacterium was isolated from the liver abscess of an 82-year-old man with a 3-week history of febrile illness. The organism was an obligate anaerobe that grew at 37 and 42؇C but not at 25؇C. Its vibrioid or spiral morphology on Gram staining, rapid progressive motility, electron micrograph features, and biochemical tests were all consistent with the organism belonging to the genus Desulfovibrio. 16S rRNA gene sequencing of this organism demonstrated a 97% similarity to Desulfovibrio desulfuricans with 45 nucleotide differences, suggesting that it is a new species of Desulfovibrio.
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