Necrotizing Pneumonia Caused by Chromobacterium violaceum: Report of a Rare Human Pathogen Causing Disease in an Immunodeficient Child

Frawley, Alean A.; Powell, Lauren; McQuiston, John R.; Gulvik, Christopher A.; Bégué, Rodolfo E.

doi:10.4269/ajtmh.18-0060

Cited by 11 publications

(8 citation statements)

References 12 publications

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“…Mortality for all C. violaceum infected patients varies from 53 to 80%, with higher risk in disseminated form of infection [ 29 ]. The mortality rate of CGD patients with C. violaceum infection is very much lower (7%) in the Southeast US [ 27 , 31 ] as compared to Malaysia at 80% (present study).…”

Section: Discussionmentioning

confidence: 54%

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Clinical and demographic pattern of chronic granulomatous disease (CGD) from a multicenter perspective: Malaysia’s experience over 26 years

Noh

Latiff

Ismail

et al. 2021

Allergy Asthma Clin Immunol

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Background A retrospective review of clinical manifestations and demographic pattern of patients diagnosed as chronic granulomatous disease (CGD) from 7 hospitals in Malaysia. An analysis of the available database would establish clinical characteristics, diagnoses and outcome including microbiologic pattern. Studying the demography allows us to document the occurrence of CGD amongst multiethnic groups and its geographical distribution for Malaysia. Methods Data from the Malaysia Primary Immunodeficiency Network (MyPIN) with cases of CGD diagnosed from 1991 until 2016 were collated and analysed. Results Twenty patients were diagnosed as CGD. Males (N = 13, 65%) outnumber females (N = 7, 35%). CGD is commonest amongst the Malays (65%) followed by the Chinese (15.0%), Indians (10.0%) and natives of Borneo (10.0%), reflecting the ethnic composition of the country. The mean age of diagnosis was 3.7 years. There was a positive family history in 40% of the cases. Abscess was the main presenting feature in 16 patients (80%) with one involving the brain. Pneumonia occurred in 10 (50%) and one with complicated bronchiectasis. Catalase-positive bacteria were the most commonly isolated pathogen with Chromobacterium violaceum predominating (N = 5, 25%) with consequent high mortality (N = 4, 80%). All CGD patients with C. violaceum infection displayed CD4 + (T helper cells) lymphopenia. Conclusion This study has shown CGD occurs in the major ethnic groups of Malaysia. To the best of our knowledge, this is the first and the largest series of chronic granulomatous disease in South East Asia which may be reflective of similar clinical pattern in the region. C. violaceum infection is associated with a higher mortality in CGD patients in Malaysia. All the CGD patients with C. violaceum infection in this patient series displayed CD4 + (T helper) lymphopenia. We recorded rare clinical manifestation of CGD viz. brain abscess and bronchiectasis.

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Section: Discussionmentioning

confidence: 54%

“…It is a gram-negative facultative anaerobe which is catalase positive dominating a variety of ecosystem in tropics and sub-tropical regions. It is a rare infection in human with less than 200 cases reported in the literature [ 27 , 28 ]. However, they can have a fulminating presentation with a high mortality [ 29 ].…”

Section: Discussionmentioning

confidence: 99%

Clinical and demographic pattern of chronic granulomatous disease (CGD) from a multicenter perspective: Malaysia’s experience over 26 years

Noh

Latiff

Ismail

et al. 2021

Allergy Asthma Clin Immunol

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“… C. violaceum typically presents with skin or soft tissue infections that can rapidly progress to multiorgan failure. Associated complications include abscesses in visceral organs, including the liver, lung, brain and spleen [ 4 ]. Predisposing conditions appear to be chronic granulomatous disease, glucose-6-phosphatase deficiency, and diabetes [ 1, 7 ].…”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…It produces a characteristic dark violet antioxidant pigment called violacein, which produces a purple colouring in colony growths [ 3 ]. It is a rare infection with fewer than 300 cases reported in the literature [ 4 ]. C. violaceum disease typically presents with skin or soft tissue infections that can rapidly progress to multiorgan failure.…”

Section: Introductionmentioning

confidence: 99%

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Chromobacterium violaceum causing disseminated soft tissue and pulmonary abscesses in a traveller returning from the Azores

Chowdhury

Lee

Wey

2021

Access Microbiology

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This case report describes a 30-year-old male patient presenting with Chromobacterium violaceum cutaneous lesions who develops a subsequent bacteraemia, complicated by soft tissue and pulmonary abscesses. C. violaceum disease is a rare infection that can manifest in a spectrum from cutaneous lesions to disseminated disease and sepsis, the latter associated with high mortality. Although in the available literature there is a recommendation for a prolonged antibiotic course, we describe effective management with a shorter course of antibiotics. This case highlights the importance of not only considering a diagnosis of C. violaceum if there has been a high risk and appropriate exposure, but to also consider the changing epidemiology of the organism due to certain geographical areas becoming warmer due to climate change.

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Chromobacterium violaceum infections in children: two case reports and literature review

Jiang,

Ren,

2024

Eur J Clin Microbiol Infect Dis

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Purpose Chromobacterium violaceum(C. violaceum) is a gram-negative bacterium that rarely infects humans, especially children. However, the mortality rate is high and there are no clear guidelines for treatment. The aim of this paper is to increase clinicians’ awareness of diseases caused by C. violaceum infections in children, to diagnose and treat them in a timely manner, to improve patient survival and to reduce mortality. Results We analysed the latest paediatric-related English language literature over the last 10 years and summarised the latest mechanisms of injury, susceptibility factors, adverse prognostic and mortality predictors, mortality rates, methods to reduce mortality, clinical manifestations, new diagnostic methods, therapeutic agents and directions for future drug development for C. violaceum. Conclusions Based on the available data, we conclude that the possibility of C. violaceum infection should be considered and diagnosed when cellulitis, septicaemia and visceral abscesses develop in children with a history of skin injury and exposure to stagnant water or soil. When clinicians strongly suspect that a child is infected with this bacterium, the recommended medication is ciprofloxacin if the child presents with severe illness. If the child has a non-severe condition, medications with relatively fewer side effects for children can be chosen, such as gentamicin, trimethoprim/ sulfamethoxazole, imipenem, and other drugs. The physician can then adjust the antimicrobial regimen based on the antimicrobial spectrum after obtaining the drug sensitivity results.

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Necrotizing Pneumonia Caused by Chromobacterium violaceum: Report of a Rare Human Pathogen Causing Disease in an Immunodeficient Child

Cited by 11 publications

References 12 publications

Clinical and demographic pattern of chronic granulomatous disease (CGD) from a multicenter perspective: Malaysia’s experience over 26 years

Clinical and demographic pattern of chronic granulomatous disease (CGD) from a multicenter perspective: Malaysia’s experience over 26 years

Chromobacterium violaceum causing disseminated soft tissue and pulmonary abscesses in a traveller returning from the Azores

Chromobacterium violaceum infections in children: two case reports and literature review

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