Chromobacterium violaceum infection in Brazil. A case report

Abstract

We report the second case of infection with Chromobacterium violaceum that occurred in Brazil. A farm worker living in the State of São Paulo presented fever and severe abdominal pain for four days. At hospitalization the patient was in a toxemic state and had a distended and painful abdomen. Chest X-ray and abdominal ultrasound revealed bilateral pneumonia and hypoechoic areas in the liver. The patient developed failure of multiple organs and died a few hours later. Blood culture led to isolation of C. violaceum resistant to ampicillin and cephalosporins and sensitive to chloramphenicol, tetracyclin, aminoglicosydes, and ciprofloxacin. Autopsy revealed pulmonary microabscesses and multiple abscesses in the liver. The major features of this case are generally observed in infections by C. violaceum: rapid clinical course, multiple visceral abscesses, and high mortality. Because of the antimicrobial resistance profile of this Gram-negative bacillus, for appropriate empirical antibiotic therapy it is important to consider chromobacteriosis in the differential diagnosis of severe community infections in Brazil.

Chromobacterium violaceum sepsis in Minas Gerais, Brazil

“…The clinical manifestations of chromobacteriosis begin after the incubation period ranging from 3 to 14 days, according to the form of exposure to the agent [1,8]. It includes inflammatory signs at the entry site, associated with fever, nausea, vomiting, abdominal pain [1,3,4] with rapid evolution to sepsis, rapid spread and high mortality [2,3,12,13]. There is formation of multiple abscesses in the lung, liver, spleen, brain (more rarely), as well as cellulite, lymphadenitis and osteomyelitis [1-3, 6, 7, 12, 14].…”

“…The Chromobacterium violaceum is a bacillus or coco-bacillus-shaped bacterium which is Gram-negative, facultative anaerobic, and usually lives in water or soil in tropical and subtropical regions [1][2][3][4][5] The most striking feature of this type of bacteria is the production of a pigment called violacein, colouring the colonies violet. However, 9% of the isolated strains do not have pigments [1].…”

“…The first description of Chromobacterium violaceum occurred in the Philippines in 1905 [3,[6][7][8], and the first report of human infection occurred in 1927 in Malaysia [1,3,7] and the Southeast Asian region has the highest number of cases reported [2,3]. In Brazil the first case was reported in 1984 and occurred in the Rio Negro region, in the Amazon [3].…”

“…The infection caused by this agent rarely affects humans, can occur in healthy or immunocompromised individuals [1,4,5], and is known as chromobacteriosis. It is characterized by rapid spread, with severe sepsis and high mortality [2,3,9]. Transmission usually occurs through contact of open wounds with contaminated water [1,3,8].…”

Chromobacterium violaceum (Schröter 1872) isolated from the aquatic environment associated with the fish culture of Jaú, Zungaro jahu (Ihering, 1898) (Siluriformes, Pimelodidae)

“…Infections in humans are rare, however, but when they occur, the mortality is high (MANJUNATH, 2007). Some studies have reported isolated cases in Brazil (MARTINEZ et al, 2000;DIAS et al, 2005) and abroad (LEE et al, 1999;TEOH et al, 2006). The aim of this study was to report the characterization of C. violaceum when isolated in a Neotropical aquatic environment, in association with the cultivation of Jaú.…”