Bacteremia caused by Helicobacter cinaedi: a case report

OBJECTIVES: Helicobacter cinaedi is a Gram-negative, spiral-shaped bacterium that primarily affects immunosuppressed patients. CASE PRESENTATION: A 49-year-old patient with ulcerative colitis diagnosed in 1992, who presented to the ED of our hospital with fever and testicular complaints. The patient was discharged with a diagnosis of left-sided acute epididymitis, which was probably sexually transmitted. At the ED, he was administered intravenous Ceftriaxone and discharged with a prescription of doxycycline for 10 days, with a good progress. Aerobic cultures were positive at three days from collection. Gram staining showed Gram-negative, corkscrew-shaped bacteria. The analysis of the blood culture bottles, and the colonies grown in Campylosel agar incubated in microaerophilic conditions at 42 °C were identified as H. cinaedi on the Maldi-TOF Biotyper 3.0 system (Bruker Diagnostics Inc.). CONCLUSIONS: Direct analysis of the blood culture bottle on the Maldi-TOF system allowed for the identification of the etiology of the bacteremia since H. cinaedi could not have been grown in standard culture conditions. The treatment of this infection is a matter of debate; however, the combination of ceftriaxone with doxycycline can be ineffective for bacteremia caused by H. cinaedi infection since it occurs by the translocation of the bacteria from the gastrointestinal tract. This type of bacteremia is associated with intestinal mucosal damage secondary to ulcerative colitis, and it primarily affects immunosuppressed patients.