Robinsoniella peoriensis was recently identified as a Gram-positive, spore-forming, anaerobic rod originally isolated from swine manure storage pits. We describe here a case of R. peoriensis bacteremia in a 42-year-old male with pancreatic cancer. The identification was confirmed by unique phenotypic profiles and partial 16S rRNA gene sequences.
CASE REPORTA 42-year-old male legal clerk presented with jaundice for 2 months. The patient had a 6-year history of chronic viral hepatitis B virus infection with secondary cirrhosis. He had been diagnosed with pancreatic cancer and had undergone surgery 10 months prior to admission. The pancreatic cancer had been diagnosed as adenocarcinoma with medium-to-low differentiation at the pancreatic tail and a tumor size of 2.5 by 2 by 3 cm as determined by biopsy and pathologic examination. The spleen and greater omentum were not involved. Immunohistochemistry staining revealed the following: p170, ϩ; CK7, ϩϩϩ; CK19, ϩϩϩ; Ki-67, ϩ (Ͼ75%); vascular endothelial growth factor, ϩϩϩ; p53, Ϫ; HER-1, Ϫ; HER-2, Ϫ. He lived in an urban area of Beijing and denied having traveled or had any animal contact in the past year. Chemotherapy had been started immediately after surgery with gemcitabine and oxaliplatin, but his jaundice continued to progress; therefore, he was admitted to the Chinese PLA General Hospital.On admission, his physical examination revealed a temperature of 36.8°C (axilla), a pulse of 78 beats/min, a respiration rate of 18 breaths/min, and a blood pressure of 120/75 mmHg. His head, eyes, ears, nose, and throat appeared normal, and his lungs were clear. Several oral ulcers were noticed, and his skin was yellowish, but no lesions were noted. Laboratory values on admission revealed the following: blood hemoglobin level, 104 g/liter; platelet count, 94 ϫ 10 9 /liter; leukocyte count, 7.97 ϫ 10 9 /liter with 71.5% neutrophils. The total bilirubin level was 107.5 mol/liter, the direct bilirubin level was 83.6 mol/liter, the total bile acid level was 373.9 mol/liter, the alanine aminotransferase level was 44.2 U/liter, and the aspartate aminotransferase level was 107.7 U/liter. He was positive for hepatitis B surface antigen, and his D-dimer level was 6.11 g/ml. Urine