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Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis

Campylobacter jejuni (C. jejuni) bacteremia is difficult to diagnose in individuals with hematological disorders undergoing chemotherapy. The cause can be attributed to the rarity of this infection, to the variable clinical presentation, and to the partial overlapping symptoms underlying the disease...

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Autores principales: Gallo, Maria Teresa, Di Domenico, Enea Gino, Toma, Luigi, Marchesi, Francesco, Pelagalli, Lorella, Manghisi, Nicola, Ascenzioni, Fiorentina, Prignano, Grazia, Mengarelli, Andrea, Ensoli, Fabrizio
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849000/
https://www.ncbi.nlm.nih.gov/pubmed/27077849
http://dx.doi.org/10.3390/ijms17040544
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author Gallo, Maria Teresa
Di Domenico, Enea Gino
Toma, Luigi
Marchesi, Francesco
Pelagalli, Lorella
Manghisi, Nicola
Ascenzioni, Fiorentina
Prignano, Grazia
Mengarelli, Andrea
Ensoli, Fabrizio
author_facet Gallo, Maria Teresa
Di Domenico, Enea Gino
Toma, Luigi
Marchesi, Francesco
Pelagalli, Lorella
Manghisi, Nicola
Ascenzioni, Fiorentina
Prignano, Grazia
Mengarelli, Andrea
Ensoli, Fabrizio
author_sort Gallo, Maria Teresa
collection PubMed
description Campylobacter jejuni (C. jejuni) bacteremia is difficult to diagnose in individuals with hematological disorders undergoing chemotherapy. The cause can be attributed to the rarity of this infection, to the variable clinical presentation, and to the partial overlapping symptoms underlying the disease. Here, we report a case of a fatal sepsis caused by C. jejuni in a 76-year-old Caucasian man with non-Hodgkin’s lymphoma. After chemotherapeutic treatment, the patient experienced fever associated with severe neutropenia and thrombocytopenia without hemodynamic instability, abdominal pain, and diarrhea. The slow growth of C. jejuni in the blood culture systems and the difficulty in identifying it with conventional biochemical phenotyping methods contributed to the delay of administering a targeted antimicrobial treatment, leading to a fatal outcome. Early recognition and timely intervention are critical for the successful management of C. jejuni infection. Symptoms may be difficult to recognize in immunocompromised patients undergoing chemotherapy. Thus, it is important to increase physician awareness regarding the clinical manifestations of C. jejuni to improve therapeutic efficacy. Moreover, the use of more aggressive empirical antimicrobial treatments with aminoglycosides and/or carbapenems should be considered in immunosuppressed patients, in comparison to those currently indicated in the guidelines for cancer-related infections supporting the use of cephalosporins as monotherapy.
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spelling pubmed-48490002016-05-04 Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis Gallo, Maria Teresa Di Domenico, Enea Gino Toma, Luigi Marchesi, Francesco Pelagalli, Lorella Manghisi, Nicola Ascenzioni, Fiorentina Prignano, Grazia Mengarelli, Andrea Ensoli, Fabrizio Int J Mol Sci Review Campylobacter jejuni (C. jejuni) bacteremia is difficult to diagnose in individuals with hematological disorders undergoing chemotherapy. The cause can be attributed to the rarity of this infection, to the variable clinical presentation, and to the partial overlapping symptoms underlying the disease. Here, we report a case of a fatal sepsis caused by C. jejuni in a 76-year-old Caucasian man with non-Hodgkin’s lymphoma. After chemotherapeutic treatment, the patient experienced fever associated with severe neutropenia and thrombocytopenia without hemodynamic instability, abdominal pain, and diarrhea. The slow growth of C. jejuni in the blood culture systems and the difficulty in identifying it with conventional biochemical phenotyping methods contributed to the delay of administering a targeted antimicrobial treatment, leading to a fatal outcome. Early recognition and timely intervention are critical for the successful management of C. jejuni infection. Symptoms may be difficult to recognize in immunocompromised patients undergoing chemotherapy. Thus, it is important to increase physician awareness regarding the clinical manifestations of C. jejuni to improve therapeutic efficacy. Moreover, the use of more aggressive empirical antimicrobial treatments with aminoglycosides and/or carbapenems should be considered in immunosuppressed patients, in comparison to those currently indicated in the guidelines for cancer-related infections supporting the use of cephalosporins as monotherapy. MDPI 2016-04-12 /pmc/articles/PMC4849000/ /pubmed/27077849 http://dx.doi.org/10.3390/ijms17040544 Text en © 2016 by the authors; licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons by Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Review
Gallo, Maria Teresa
Di Domenico, Enea Gino
Toma, Luigi
Marchesi, Francesco
Pelagalli, Lorella
Manghisi, Nicola
Ascenzioni, Fiorentina
Prignano, Grazia
Mengarelli, Andrea
Ensoli, Fabrizio
Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis
title Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis
title_full Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis
title_fullStr Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis
title_full_unstemmed Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis
title_short Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis
title_sort campylobacter jejuni fatal sepsis in a patient with non-hodgkin’s lymphoma: case report and literature review of a difficult diagnosis
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4849000/
https://www.ncbi.nlm.nih.gov/pubmed/27077849
http://dx.doi.org/10.3390/ijms17040544
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