Life-threatening Infections in Medically Immunocompromised Patients

Al‐Dorzi, Hasan M.; Khan, Raymond; Arabi, Yaseen M.

doi:10.1016/j.ccc.2013.06.002

Cited by 5 publications

(3 citation statements)

References 147 publications

(180 reference statements)

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“…Renal diseases, including ESRD, are also considered as potential risk factors for Vibrio vulnificus infection. Dysfunctions of neutrophils, monocytes, and lymphocytes observed in uremia could play a role in increasing the risk of certain life-threatening infections in these patients [5]. Moreover, Vibrio vulnificus is known to grow rapidly in iron rich environments, a situation commonly encountered among dialysis patients who frequently need blood transfusions or iron supplementation to correct anemia [6,7].…”

Section: Discussionmentioning

confidence: 99%

Septicemia, necrotizing fasciitis, and peritonitis due to Vibrio vulnificus treated with early use of polymyxin B hemoperfusion in a patient undergoing CAPD: a case report

et al. 2020

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Background: Vibrio vulnificus infection is a rare but fatal foodborne illness. Here, we report a case of Vibrio vulnificus peritonitis followed by severe septicemia in a patient undergoing continuous ambulatory peritoneal dialysis (CAPD) who was treated with hemoperfusion using polymyxin B immobilized fiber. Case presentation: A 63-year-old man undergoing CAPD was admitted to the emergency room due to general weakness, fever, and abdominal pain with hazy dialysate. Two days before admission, he had eaten raw fish. Initial laboratory tests including peritoneal fluid analysis suggested peritonitis. Despite empirical intraperitoneal antibiotic treatment, his fever did not subside, and multiple vesicles on the extremities newly appeared. The result of initial peritoneal fluid culture and blood cultures reported Vibrio vulnificus as the most likely causative pathogen. Hemoperfusion with polymyxin B immobilized fiber was performed to control gram-negative bacterial septicemia with antibiotics targeting the pathogenic organism. The patient recovered completely and was discharged without complications. Discussion and conclusion: Suspicion of Vibrio vulnificus infection in susceptible immunocompromised patients is important for early diagnosis and prompt management. Peritonitis should be noted as a clinical manifestation of Vibrio vulnificus infection in CAPD patients, and polymyxin B hemoperfusion along with proper antibiotics could be considered as a treatment option.

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Section: Discussionmentioning

confidence: 99%

Septicemia, necrotizing fasciitis, and peritonitis due to Vibrio vulnificus treated with early use of polymyxin B hemoperfusion in a patient undergoing CAPD: a case report

et al. 2020

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“…Moreover, kidney diseases, including ESRD, are regarded as other potential contributing risk factors for V. vulnificus infection. Functional abnormalities of neutrophils, monocytes, dendritic cells, and lymphocytes have been observed in uremia, which makes patients prone to specific life-threatening infections [ 10 ]. In addition, dialysis patients have frequently elevated iron levels because of blood transfusion or iron supplement for significant anemia.…”

Section: Discussionmentioning

confidence: 99%

Severe septicemia, necrotizing fasciitis, and peritonitis due to Vibrio vulnificus in a patient undergoing continuous ambulatory peritoneal dialysis: a case report

et al. 2015

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BackgroundChronic kidney disease, including end-stage renal disease, has been identified as a possible risk factor for primary septicemia and wound infection by Vibrio vulnificus. However, cases of severe septicemia, necrotizing fasciitis, and peritonitis caused by V. vulnificus in patients undergoing continuous ambulatory peritoneal dialysis (CAPD) have not been described. We report a case of severe septicemia, necrotizing fasciitis, and peritonitis due to V. vulnificus in a patient undergoing CAPD after ingesting raw seafood.Case presentationA 37-year-old woman undergoing CAPD was admitted to the emergency room due to general weakness, fever, diarrhea, and abdominal pain. Although empirical intraperitoneal antibiotics were administered for the diagnosis of CAPD-related peritonitis, her fever did not subside. On hospital day 3, she had hemorrhagic bullae on both lower legs. We evaluated her recent food history, and found that she ate raw seafood before admission. She underwent emergency fasciotomy on the suspicion of necrotizing fasciitis by V. vulnificus infection. Finally, V. vulnificus was confirmed by 16S ribosomal ribonucleic acid gene sequencing using blood and peritoneal effluent fluid cultures. The administration of intraperitoneal ceftazidime and intravenous ciprofloxacin/ceftriaxone was continued for 4 weeks, and the patient completely recovered.ConclusionsSuspicion of V. vulnificus infection in vulnerable patients who ingest raw seafood is essential for prompt diagnosis, which could significantly improve patient outcomes.

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“…The complication of oral mucositis was considered to be highly responsible for the infection and an importance of oral hygiene in neutropenic patients has been emphasized (12). Patients with heart failure are generally immunocompromised (16) and prone to dry mouth (17), possibly leading to deteriorated oral hygiene. However, our case was unique in that there were no such underlying conditions, indicating that Capnocytophaga can infect any patients without these predisposing factors.…”

Section: Discussionmentioning

confidence: 99%

<i>Capnocytophaga ochracea</i>-related Bacterium Bacteremia in a Hypertrophic Cardiomyopathy Patient without Neutropenia

et al. 2016

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Gram-negative fusiform rods were detected in a blood culture obtained from a 63-year-old man who had been hospitalized for a long duration for severe heart failure. Although the organism could not be identified using a conventional method, it was finally identified as a bacterium of the Capnocytophaga ochracea group based on the results of biochemical testing, 16S rRNA sequencing and a matrix-assisted laser desorption ionization time-of-flight mass spectrometry analysis. Although neutropenic patients with poor oral hygiene are exclusively vulnerable to Capnocytophaga bacteremia, this case was unique because such predisposing conditions were not noted. A multi-centered investigation is warranted for a better understanding of this clinically rare, but potentially pathogenic organism.

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Life-threatening Infections in Medically Immunocompromised Patients

Cited by 5 publications

References 147 publications

Septicemia, necrotizing fasciitis, and peritonitis due to Vibrio vulnificus treated with early use of polymyxin B hemoperfusion in a patient undergoing CAPD: a case report

Septicemia, necrotizing fasciitis, and peritonitis due to Vibrio vulnificus treated with early use of polymyxin B hemoperfusion in a patient undergoing CAPD: a case report

Severe septicemia, necrotizing fasciitis, and peritonitis due to Vibrio vulnificus in a patient undergoing continuous ambulatory peritoneal dialysis: a case report

<i>Capnocytophaga ochracea</i>-related Bacterium Bacteremia in a Hypertrophic Cardiomyopathy Patient without Neutropenia

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