A case of Leclercia adecarboxylata endocarditis in a 62-year-old man.

Malik, Kashif; Davie, Ryann; Withers, Allison; Faisal, Mohammad; Lawal, Folake

doi:10.1016/j.idcr.2021.e01091

Cited by 5 publications

(17 citation statements)

References 11 publications

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“…L. adecarboxylata is implicated in cases which involve endocarditis [15,16], catheterrelated bacteremia [10,17,18], bacteremia and cellulitis [5,6,9,19,20], urinary tract infections [6,21], pneumonia [5,22] and bacterial peritonitis, especially in peritoneal dialysis patient [7,[11][12][13][14], which was the case for the majority of our clinical presentations. L. adecarboxylata was most often found as a monomicrobial infection in immunocompromised patients, and as part of a polymicrobial infection in immunocompetent patients [5,12].…”

Section: Discussionmentioning

confidence: 85%

Leclercia adecarboxylata as Emerging Pathogen in Human Infections: Clinical Features and Antimicrobial Susceptibility Testing

et al. 2021

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(1) Background: Leclercia adecarboxylata (L. adecarboxylata) is a gram-negative bacillus of the Enterobacteriaceae family, which is uncommonly isolated from clinical specimens. L. adecarboxylata is considered as an aquatic opportunistic pathogen and most of the human infections are polymicrobial and usually occur in immunocompromised hosts. (2) Methods: In this retrospective study, we included all L. adecarboxylata strains since the introduction of MALDI-TOF MS in the Microbiology Department of Nord Franche-Comté Hospital, France (from 1 March 2015 to 31 July 2019). We studied demographic characteristics, comorbidities, characteristics of the current infection and outcome as well as antimicrobial susceptibility testing in all isolates. (3) Results: A total of 8 samples were identified (in 6 patients (4M/2F), with a recurrent L. adecarboxylata infection in 2 patients). The patients’ mean age was 66.2 years (range: 19–84). All patients were considered as immunocompetent, except a peritoneal dialysis patient with kidney transplantation. An exposition to an aquatic environment was identified in one patient. The most prevalent clinical feature was catheter-associated male urinary tract infection (in 3 cases) followed by ventilator-associated pneumonia (in 2 cases). One of 6 patients presented L. adecarboxylata bacteremia. L. adecarboxylata was part of a polymicrobial infection in 4 patients. The isolates showed a high susceptibility to all tested antibiotics, except one strain, which was resistant to fosfomycin. All patients with L. adecarboxylata infection were treated with antibiotics with a favorable outcome. (4) Conclusion: This study confirms the pathogenicity of L. adecarboxylata, even in immunocompetent patients, with a high susceptibility to antibiotics.

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Section: Discussionmentioning

confidence: 85%

Leclercia adecarboxylata as Emerging Pathogen in Human Infections: Clinical Features and Antimicrobial Susceptibility Testing

et al. 2021

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“…A few cases with diabetes as the only risk factor have L. adecarboxylata infection of the skin and soft tissues[ 81 , 82 ]. L. adecarboxylata has been implicated in endocarditis[ 6 ], catheter-associated bacteremia[ 78 ], bacteremia, sepsis[ 3 , 67 ], septic arthritis, meningitis[ 83 ], cellulitis[ 2 , 84 ], urinary tract infections[ 85 ], pneumonia[ 70 ], and bacterial peritonitis, especially in patients on peritoneal dialysis[ 86 ]. Of these, the most common clinically are catheter-associated male urinary tract infections (translocation through the genitourinary tract), followed by ventilator-associated pneumonia, peritoneal dialysis peritonitis, corneal abscesses, vascular graft infections (entry into the infected host via catheter or wound)[ 87 ], and intestinal translocation (translocation of bacteria through the mucosal barrier of the gastrointestinal tract, presumably gastrointestinal bacteremia)[ 2 , 70 ].…”

Section: Discussionmentioning

confidence: 99%

“…Echocardiography showed formation of a vegetation in the anterior mitral leaflet, and cultures of blood and vegetation showed L. adecarboxylata infection. Of the reported cases of endocarditis in the world, only three were caused by L. adecarboxylata [ 4 - 6 ]. To our knowledge, this is the first case of L. adecarboxylata endocarditis in China.…”

Section: Discussionmentioning

confidence: 99%

“…In our case, L. adecarboxylata was the only pathogen isolated from bacterial cultures in an immunocompetent patient, and there are only three existing case reports of monomicrobial L. adecarboxylata infection in immunocompetent patients[ 74 ]. Of the case reports of endocarditis found worldwide, only three cases of endocarditis were caused by L. adecarboxylata [ 4 - 6 ]. We report the first case of IE caused by L. adecarboxylata in China.…”

Section: Discussionmentioning

confidence: 99%

“…Infective endocarditis (IE) caused by L. adecarboxylata is a very rare disease in the clinic. Only three cases of L. adecarboxylata endocarditis have been reported in the existing literature[ 4 - 6 ]. Herein we report a case of L. adecarboxylata endocarditis complicated with severe mitral stenosis, atrial fibrillation, and acute cerebral infarction.…”

Section: Introductionmentioning

confidence: 99%

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Leclercia adecarboxylata infective endocarditis in a man with mitral stenosis: A case report and review of the literature

Tan¹,

Yu²,

Wang³

et al. 2022

World J Clin Cases

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BACKGROUND Infective endocarditis (IE) is a rare disease with a high mortality rate. Leclercia adecarboxylata ( L. adecarboxylata ) is a movable Gram-negative bacillus of enterobacteriaceae, and it can rarely be a pathogen which often affects immunodeficient patients. There are about three cases of immunocompetent patients with monomicrobial L. adecarboxylata infection. There are only three reported cases of IE caused by L. adecarboxylata in the world. The mitral valve is often affected in IE, and the prognosis for IE with mitral valve lesions is often poor. CASE SUMMARY A 51-year-old man was found to have moderate to severe mitral stenosis on echocardiography. He came to our Cardiothoracic Surgery Department for surgical management. A diastolic murmur was heard on auscultation of the heart in the mitral region. On the second day of hospitalisation, he presented with slurred speech, reduced muscle strength in the left limb, and acute cerebral infarction on cranial computed tomography. Surgical treatment was decided to postpone. On the ninth day of admission, the patient developed a sudden high fever and shock and was transferred to the Cardiac Intensive Care Unit, where echocardiogram revealed an anterior mitral valve leaflet vegetation. After empirical anti-infective treatment with vancomycin (1g q12h), an emergency valve replacement was performed. Bacterial culture identified L. adecarboxylata . Anti-infective treatment with piperacillin-tazobactam (4.5g q8h) was added for 4 wk. Follow-up echocardiography showed normal bioprosthetic valve function after mitral valve replacement. CONCLUSION We report the first case of L. adecarboxylata IE in China, and clinicians should pay attention to this pathogen.

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Case report: A rare case of Leclercia adecarboxylata bacteremia in an immunocompetent psychiatric patient: exploring the links between mental health and infectious diseases

Yan,

Ruan,

Tang

et al. 2024

Front. Immunol.

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This study aims to explore the pathogenic potential of Leclercia adecarboxylata as a rare pathogen in immunocompetent individuals and to analyze how mental health status may influence susceptibility to infection. We report a case of bacteremia in a 31-year-old immunocompetent female who developed L. adecarboxylata infection during an episode of severe depression. Although the patient exhibited self-harm tendencies, a thorough physical examination did not reveal any external wounds or signs of injury. This case demonstrates that, despite the absence of obvious external infection sources, invasive procedures, or visible trauma, L. adecarboxylata can induce severe bacteremia in immunocompetent individuals. The patient presented with high fever and systemic inflammatory response, with blood cultures confirming the presence of L. adecarboxylata, and chest imaging showing bilateral lower lobe inflammation. Following treatment with ceftriaxone, the patient’s symptoms rapidly improved, and infection markers normalized. This study elucidates the potential mechanisms by which L. adecarboxylata can cause infection in immunocompetent individuals and examines the influence of mental health on infection susceptibility. It provides new insights into the complex relationship between mental illness and infection, highlighting the need for further investigation into how mental health may affect infection risk and its clinical management. In conjunction with existing research, this study discusses how psychological stress and behavioral patterns may increase infection risk and recommends future research to further explore the interplay between mental disorders and infectious diseases.

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A case of Leclercia adecarboxylata endocarditis in a 62-year-old man.

Cited by 5 publications

References 11 publications

Leclercia adecarboxylata as Emerging Pathogen in Human Infections: Clinical Features and Antimicrobial Susceptibility Testing

Leclercia adecarboxylata as Emerging Pathogen in Human Infections: Clinical Features and Antimicrobial Susceptibility Testing

Leclercia adecarboxylata infective endocarditis in a man with mitral stenosis: A case report and review of the literature

Case report: A rare case of Leclercia adecarboxylata bacteremia in an immunocompetent psychiatric patient: exploring the links between mental health and infectious diseases

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