Bromhidrosis Induced by Sphingomonas Paucimobilis: A Case Report

Abstract

Bromhidrosis is a clinical disorder characterized by excessive or abnormal foul axillary odour due to the interaction of apocrine glands with micro-organisms which causes a serious personal and social handicap for affected people. We present the case of a 50-year-old caucasian female with bromhidrosis. The patient referred that this symptom had begun two months previously. Her past treatments included antibacterial soap, topical antibacterial agents and perfumes, but none of these relieved the patient of the odour. A cultural examination of axillary smear was carried out and it revealed the presence of ciproftoxacin sensible Sphingomonas paucimobilis. Therefore the patient was treated with ciproftoxacin and after 1 week the infection resolved completely.Bromhidrosis is a common but unpleasant disease faced by many populations, particularly in Asia, due to the interaction of apocrine glands with microorganisms. Axillary bacteria degrade the apocrine sweat and malodorous smell develops within a few hours. The major odour components are short-chain fatty acids and ammonia (1). However, the definite etiology ofbromhidrosis has not yet been generalized. To our knowledge, this is the first report of axillary bromhidrosis caused by Sphingomonas paucimobilis. MATERIALS AND METHODSA 50-year-old caucasian female was referred to our Department in May 2008, because of a disagreeable odour due to axillary bromhidrosis. Past medical history was unremarkable; the dermatological examination showed no abnormalities and there were no superficial axillary lymphadenopathy; laboratory tests were normal. The patient referred that this symptom had begun two months previously. Her past treatments had included antibacterial soap, topical antibacterial agents, and perfumes, but none of these relieved the patient of the odour. An axillary smear was performed and processed according to standard microbiologic techniques in the Microbiology laboratory of "Umberto I" Hospital in Rome. In particular, the specimen was cultured on Sabouraud agar for yeasts and on routinely selective and elective culture media for bacteria and it was incubated in ambient air at 37°C for 24-48 hours. Macroscopic observation of the microbial colony, Gram staining, the motility assay and catalase tests were performed

Risk factors associated with Sphingomonas paucimobilis infection

“…9e11 S paucimobilis can cause a variety of infections in both healthy people and immunocompromised hosts. Clinical syndrome associated with S paucimobilis include primary bacteremia, intravascular catheter infections, peritoneal dialysis-associated peritonitis, 12 urinary tract infection, biliary tract infection, cutaneous infection, 13 ventilator-associated pneumonia, 14 meningitis, 15 myositis, 16 osteomyelitis, 17 septic arthritis, 18,19 endophthalmitis, 20,21 cervical adenitis, 9 bromohidrosis, 22 and diarrheal disease. 6 Most S paucimobilis infections reported in the literature were either hospital acquired or related to nosocomial outbreaks.…”

Treatment of bromhidrosis with a glycine-soja sterocomplex topical product

“…12 Antibiotics can help in cases where sensitive bacteria are identified. 13 Even though the population in this study was a small sample, the glycine-soja sterocomplex topical agent showed encouraging improvement on both the intensity and quality of odor in patients with bromhidrosis and also a profound improvement on the patients' quality of life without adverse events.…”

“…Surgical procedures, such as superficial ultrasound‐assisted lipoplasty, and combined operation with CO2 laser and subcutaneous tissue removal are often complicated with adverse events 12 . Antibiotics can help in cases where sensitive bacteria are identified 13 . Even though the population in this study was a small sample, the glycine‐soja sterocomplex topical agent showed encouraging improvement on both the intensity and quality of odor in patients with bromhidrosis and also a profound improvement on the patients’ quality of life without adverse events.…”

The Gram-Negative Bacilli Isolated from Caves—Sphingomonas paucimobilis and Hafnia alvei and a Review of Their Involvement in Human Infections

“…No duplicates were found. We included in our analysis 447 cases—262 S. paucimobilis infections and 185 H. alvei infections ( Figure 3 ) [ 34 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 , 54 , 55 , 56 , 57 , 58 , 59 , 60 , 61 , 62 , 63 , 64 , 65 , 66 , 67 , 68 , 69 , 70 , 71 , 72 , 73 , 74 , 75 , 76 , 77 , 78 , 79 , 80 , 81 , 82 , 83 , 84 ].…”