A case report of the differential diagnosis of Cellulosimicrobium cellulans-infected endocarditis combined with intracranial infection by conventional blood culture and second-generation sequencing

Abstract

Background Cellulosimicrobium cellulans is a gram-positive filamentous bacterium found primarily in soil and sewage that rarely causes human infection, especially in previously healthy adults, but when it does, it often indicates a poor prognosis. Case presentation We report a case of endocarditis and intracranial infection caused by C. cellulans in a 52-year-old woman with normal immune function and no implants in vivo. The patient started with a febrile headache that progressed to impaired consciousness after 20 days, and she finally died after treatment with vancomycin combined with rifampicin. C. cellulans was isolated from her blood cultures for 3 consecutive days after her admission; however, there was only evidence of C. cellulans sequences for two samples in the second-generation sequencing data generated from her peripheral blood, which were ignored by the technicians. No C. cellulans bands were detected in her cerebrospinal fluid by second-generation sequencing. Conclusions Second-generation sequencing seems to have limitations for certain specific strains of bacteria.

Cellulosimicrobium Infections in Humans—A Narrative Review

“…The literature search yielded 133 studies. After screening all potentially eligible articles and assessing the references of the included articles, only 38 studies met the inclusion criteria and were considered for data extraction [ 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 ]. These 38 studies provided information on 40 patients.…”

“…The genus Cellulosimicrobium was proposed in 2001 by Schumann et al and replaced the nomenclature of Oerskovia and other relevant bacteria, such as Cellulomonas cellulans [ 4 ]. They rarely cause infections in humans, with only a few dozen cases being described in the literature until now [ 5 ]. Most studies on this pathogen are case reports with brief literature reviews.…”

“…Most studies on this pathogen are case reports with brief literature reviews. These infections often occur in patients who are immunocompromised or have other underlying conditions [ 5 ]. Due to the rarity of this microorganism, its pathogenic potential, as well as the epidemiological, clinical, and microbiological characteristics associated with these infections, have not been adequately described.…”

Antimicrobial-Resistant Bacteria from Free-Living Green Turtles (Chelonia mydas)

“…For ciprofloxacin, three species were found to express resistance: C. cellulans , E. coli , and P. mirabilis . The genus Cellulosimicrobium is reported to exhibit resistance genes [ 32 , 33 ]. Ciprofloxacin-resistant and gentamicin-resistant C. cellulans were also isolated in neck samples.…”

“…Ciprofloxacin-resistant and gentamicin-resistant C. cellulans were also isolated in neck samples. C. cellulans is commonly found in soil or surface waters and causes rare human infections [ 33 ]. Citrobacter is an opportunistic pathogen in some animals that causes severe aquaculture issues, leading to fish mortality.…”