The Brief Case: Recurrent Chromobacterium violaceum Bloodstream Infection in a Glucose-6-Phosphate Dehydrogenase (G6PD)-Deficient Patient with a Severe Neutrophil Defect

Thwe, Phyu M.; Ortiz, Daniel A.; Wankewicz, Alyssa L.; Hornak, J. Patrik; Williams‐Bouyer, Natalie; Ren, Ping

doi:10.1128/jcm.00312-19

Cited by 6 publications

(5 citation statements)

References 13 publications

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“…Active antimicrobial agents include chloramphenicol, fluoroquinolones, aminoglycosides, carbapenems, piperacillin-tazobactam, tetracycline and trimethoprim-sulfamethoxazole. 4,5,14 As with previous studies, these current case outcomes reflect complete clinical examination with proper history of patient will help reveal uncommon etiology. Early intervention with admistration of antimicrobial therapy is crucial to effectively manage severe life-threatening infections.…”

Section: Blood Agarsupporting

confidence: 66%

“…[11][12][13] C. violaceum septicaemia is highly fatal due to its ability to spread rapidly owing to the presence of one polar and one or two subpolar or lateral flagella 11 and secretion of an extracellular protein collagenase. 14 Fatality as high as 65% has been reported. 5 Nearly all cases of septicaemia are preceded by wound infection, as also seen in our case.…”

Section: Blood Agarmentioning

confidence: 99%

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Chromobacterium violaceum: A report of two cases of septicaemia and wound infection

Anjum¹,

Mustafa²,

Khaleel³

2021

IJMMTD

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Background: Chromobacterium violaceum is a rare cause of human infection, which may become life threatening to its' ability to rapidly disseminate. Cases are few and far between but with the climate change can increase in number. Here we discuss two (2) cases of infection with C. violaceum isolated at our hospital in South India. Materials and Methods: Samples collected with all aseptic precautions were subjected for aerobic culture and the isolates subjected to various biochemical tests for identification. Result: Infection by C. violaceum was confirmed in both the cases and appropriate antimicrobial administered. Conclusion: Timely treatment with appropriate antimicrobial agents can reduce morbidity and prevent mortality by halting the progression of a local infection to systemic disease.

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Section: Blood Agarsupporting

confidence: 66%

Section: Blood Agarmentioning

confidence: 99%

Chromobacterium violaceum: A report of two cases of septicaemia and wound infection

Anjum¹,

Mustafa²,

Khaleel³

2021

IJMMTD

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“…Ultimately, 15 patients in 11 studies with severe G6PD deficiency and infections were reviewed in PubMed ( Cooper et al, 1972 ; Gray et al, 1973 ; Vives Corrons et al, 1982 ; Roos et al, 1999 ; Rosa-Borges et al, 2001 ; Spolarics et al, 2001 ; Costa et al, 2002 ; van Bruggen et al, 2002 ; Khan et al, 2017 ; Siler et al, 2017 ; Thwe et al, 2020 ), which might be explained by neutrophil dysfunction. The PRISMA flow diagram is shown in Figure 4 , and the data are summarized in Table 3 .…”

Section: Resultsmentioning

confidence: 99%

Severe G6PD deficiency leads to recurrent infections and defects in ROS production: Case report and literature review

Sun

Dong

et al. 2022

Front. Genet.

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Purpose: Severe glucose-6-phosphate dehydrogenase (G6PD) deficiency can lead to reduced nicotinamide adenine dinucleotide phosphate oxidase activity in phagocytes, resulting in immunodeficiency, with a limited number of reported cases. Here, we aimed to report a child with severe G6PD deficiency in China and investigate the mechanism of his recurrent infections.Methods: The clinical manifestations and immunological phenotypes of this patient were retrospectively collected. Gene mutation was detected by whole-exome sequencing and confirmed by Sanger sequencing. Dihydrorhodamine (DHR) analysis was performed to measure the respiratory burst of neutrophils. Messenger ribonucleic acid and protein levels were detected in the patient under lipopolysaccharide stimulation by real-time quantitative reverse transcription polymerase chain reaction and Western blot. A review of the literature was performed.Results: A male child with G6PD deficiency presented with recurrent respiratory infections, Epstein‒Barr virus infection and tonsillitis from 8 months of age. Gene testing revealed that the proband had one hemizygous mutation in the G6PD gene (c.496 C>T, p. R166C), inherited from his mother. This mutation might affect hydrophobic binding, and the G6PD enzyme activity of the patient was 0. The stimulation indexes of the neutrophils in the patient and mother were 22 and 37, respectively. Compared with healthy controls, decreased reactive oxygen species (ROS) production was observed in the patient. Activation of nuclear factor kappa-B (NF-κB) signaling was found to be influenced, and the synthesis of tumor necrosis factor alpha (TNF-α) was downregulated in the patient-derived cells. In neutrophils of his mother, 74.71% of the X chromosome carrying the mutated gene was inactivated. By performing a systematic literature review, an additional 15 patients with severe G6PD deficiency and recurrent infections were identified. Four other G6PD gene mutations have been reported, including c.1157T>A, c.180_182del, c.514C>T, and c.953_976del.Conclusion: Severe G6PD deficiency, not only class I but also class II, can contribute to a chronic granulomatous disease-like phenotype. Decreased reactive oxygen species synthesis led to decreased activation of the NF-κB pathway in G6PD-deficient patients. Children with severe G6PD deficiency should be aware of immunodeficiency disease, and the DHR assay is recommended to evaluate neutrophil function for early identification.

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“…To our knowledge, no guidelines currently exist for the interpretation of the antimicrobial sensitivity test data for C violaceum , most likely owing to their rarity in clinical settings. [ 9 ] C violaceum is highly resistant to ampicillin, penicillin, and cephalosporin but sensitive to fluoroquinolones, aminoglycosides, and carbapenems. In our study, the organism isolated from the skin infection was sensitive to piperacillin/tazobactam, cefperazone/sulbactam, tigecycline, meropenem, imipenem, levofloxacin, ciprofloxacin, and amikacin.…”

Section: Discussionmentioning

confidence: 99%

Chromobacterium violaceum infection on lower limb skin

Zhang

Li²,

Zhang³

et al. 2021

Medicine

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Rational: Chromobacterium violaceum is a motile gram-negative bacterium. This bacterium commonly grows in tropical or subtropical areas in sewage and can cause opportunistic infections. Patient concerns: A 50-year-old Chinese man had a skin ulcer in the middle of his left leg in front of the tibia. The diameter of the wound was 3.0 cm, the exudation was obvious, and necrotic tissue was attached to the wound. One week previously, he was working in a field where he accidentally punctured his left leg. Diagnosis: C violaceum infection was diagnosed as per the results of pathogen culture from the infection site. Interventions: He was treated with piperacillin/tazobactam (3.375 g/12 h iv) and levofloxacin (0.5 g/24 h iv) for 5 days. Outcomes: The patient showed good response to therapy and was discharged on day 18 after wound healing. Lessons: C violaceum rarely infects humans. When an infection is suspected, samples should be immediately sent for microbial culture. Timely treatment on the basis of drug sensitivity test results can prevent further complications.

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The Brief Case: Recurrent Chromobacterium violaceum Bloodstream Infection in a Glucose-6-Phosphate Dehydrogenase (G6PD)-Deficient Patient with a Severe Neutrophil Defect

Abstract: The Brief Case: Recurrent Chromobacterium violaceum bloodstream infection in a glucose-6-phosphate dehydrogenase (G6PD)-deficient patient with a severe neutrophil defect.

Cited by 6 publications

References 13 publications

Chromobacterium violaceum: A report of two cases of septicaemia and wound infection

Chromobacterium violaceum: A report of two cases of septicaemia and wound infection

Severe G6PD deficiency leads to recurrent infections and defects in ROS production: Case report and literature review

Chromobacterium violaceum infection on lower limb skin

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