Cutaneous manifestations ofHelicobacter cinaedi: a review

Abstract

Helicobacter cinaedi is an emerging Gram-negative spiral bacillus that was first reported in 1984. It has been implicated as a cause of gastroenteritis and bacteraemia in immunocompromised individuals. Helicobacter cinaedi-associated bacteraemia is sometimes accompanied by skin lesions; however, the cutaneous manifestations of this pathogen are not widely known. To our knowledge, a comprehensive review with detailed analysis of skin lesions associated with H. cinaedi has not been conducted. This article summarizes the clinical appearance of H. cinaedi cellulitis and its management. In addition, we conducted a retrospective review of 73 patients with H. cinaedi bacteraemia at a single institution, to further clarify the characteristic cutaneous features. It was found that 30% (22/73) of the cases of H. cinaedi bacteraemia had sudden-onset erythema accompanied by high fever. The most common cutaneous symptom of H. cinaedi bacteraemia was found to be mild cellulitis, appearing as multiple painful infiltrated erythemas on the extremities. As H. cinaedi is not always detectable in routine blood culture techniques, evaluation of these characteristic cutaneous manifestations seems important in diagnosis. Helicobacter cinaedi infection should be added to the diagnostic list of unspecified fever with painful infiltrated erythemas.

Chronic Helicobacter cinaedi cellulitis diagnosed by microbial polymerase chain reaction

“…H cinaedi infections generally respond to extended courses of penicillins, carbapenems, aminoglycosides, or tetracyclines. 3 The lack of response of our patient's rash to TMP-SMX prescribed for epididymitis is in line with documented resistance of H cinaedi to that antibiotic. 4 …”

“…According to a retrospective review of 73 mostly immunocomprimised patients with H cinaedi bacteremia, skin lesions occur in 30% of patients and appear as erythematous patches and plaques on the extremities. 3 Skin biopsy often finds a mixed inflammatory infiltrate in the dermis and subcutis. Diagnosis is very difficult by traditional culture techniques.…”

“…The authors of the previously mentioned study examined tissue culture and bacterial stains of skin lesions of 6 patients with H cinaedi bacteremia, and all were found to be negative. 3 Correct diagnosis requires a high index of suspicion and microbiologic confirmation. H cinaedi infections generally respond to extended courses of penicillins, carbapenems, aminoglycosides, or tetracyclines.…”

Helicobacter cinaedi – an emerging form of cellulitis

“…This new paper reports 43 cases occurring over a 3‐year period in Hokkaido, Japan . The report pinpoints some potentially helpful clinical differences between these cases and the more conventional streptococcal cellulitis.…”

Pyoderma gangrenosum‐like ulcer caused by Helicobacter cinaedi in a patient with hypogammaglobulinemia

“…Surprisingly, the cutaneous ulcer was induced by H. cinaedi, a causative agent in recurrent cellulitis. 1 There are few cases reports of cutaneous ulcers caused by H. cinaedi. 2,3 These reports described the similarities between the ulcers caused by H. cinaedi and by pyoderma gangrenosum.…”