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A cardiac implantable device infection by Raoultella planticola in an immunocompromized patient

Introduction. Infection of cardiac implantable electronic devices is a severe condition associated with high mortality, particularly in patients who are dependent upon heart-pacing devices. Staphylococci are found in 70 % of reported cases. Case presentation. We report the case of a cardiac-pacemake...

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Autores principales: Adjodah, Chandra, D'Ivernois, Chistophe, Leyssene, David, Berneau, Jean-Baptiste, Hemery, Yann
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Microbiology Society 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5361635/
https://www.ncbi.nlm.nih.gov/pubmed/28348805
http://dx.doi.org/10.1099/jmmcr.0.005080
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author Adjodah, Chandra
D'Ivernois, Chistophe
Leyssene, David
Berneau, Jean-Baptiste
Hemery, Yann
author_facet Adjodah, Chandra
D'Ivernois, Chistophe
Leyssene, David
Berneau, Jean-Baptiste
Hemery, Yann
author_sort Adjodah, Chandra
collection PubMed
description Introduction. Infection of cardiac implantable electronic devices is a severe condition associated with high mortality, particularly in patients who are dependent upon heart-pacing devices. Staphylococci are found in 70 % of reported cases. Case presentation. We report the case of a cardiac-pacemaker infection in a 79-year-old man, cumulating a history of rheumatoid arthritis treated by corticosteroids and methotrexate by a recently identified micro-organism: Raoultella planticola. He presented local signs of infection on his VVI pacemaker implantation site and underwent urgent pocket device replacement under cefamandole antibioprophylaxis. On incision thick pus oozed out. It was necessary to perform a complete hardware extraction comprising the pulse generator and the ancient lead. Pus was inoculated into aerobic and anaerobic culture vials and Gram staining unveiled Gram-negative rods. Microbiology analysis identified the organism as R. planticola. A new pacing device was inserted on the contrlateral pectoral region. Ciprofloxacin enabled full recovery. A literature review concerning this pathogen revealed that it is involved in severe infections such as bloodstream infections, peritonitis, cellulitis, pneumonia and lung abscesses, and urinary tract infections. In these case reports, underlying co-morbidities were identified such as solid active neoplasia, recent chemotherapy, corticosteroids, solid-organ-recipient patients and recent open surgery. Conclusion. R. planticola is a serious emerging pathogen and contributes to the burden of various infectious conditions. Its pathogenicity and occurrence should be known by clinicians and a high level of awareness is necessary to precisely identify it provide the correct antibiotic regimen.
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spelling pubmed-53616352017-03-27 A cardiac implantable device infection by Raoultella planticola in an immunocompromized patient Adjodah, Chandra D'Ivernois, Chistophe Leyssene, David Berneau, Jean-Baptiste Hemery, Yann JMM Case Rep Case Report Introduction. Infection of cardiac implantable electronic devices is a severe condition associated with high mortality, particularly in patients who are dependent upon heart-pacing devices. Staphylococci are found in 70 % of reported cases. Case presentation. We report the case of a cardiac-pacemaker infection in a 79-year-old man, cumulating a history of rheumatoid arthritis treated by corticosteroids and methotrexate by a recently identified micro-organism: Raoultella planticola. He presented local signs of infection on his VVI pacemaker implantation site and underwent urgent pocket device replacement under cefamandole antibioprophylaxis. On incision thick pus oozed out. It was necessary to perform a complete hardware extraction comprising the pulse generator and the ancient lead. Pus was inoculated into aerobic and anaerobic culture vials and Gram staining unveiled Gram-negative rods. Microbiology analysis identified the organism as R. planticola. A new pacing device was inserted on the contrlateral pectoral region. Ciprofloxacin enabled full recovery. A literature review concerning this pathogen revealed that it is involved in severe infections such as bloodstream infections, peritonitis, cellulitis, pneumonia and lung abscesses, and urinary tract infections. In these case reports, underlying co-morbidities were identified such as solid active neoplasia, recent chemotherapy, corticosteroids, solid-organ-recipient patients and recent open surgery. Conclusion. R. planticola is a serious emerging pathogen and contributes to the burden of various infectious conditions. Its pathogenicity and occurrence should be known by clinicians and a high level of awareness is necessary to precisely identify it provide the correct antibiotic regimen. Microbiology Society 2017-02-28 /pmc/articles/PMC5361635/ /pubmed/28348805 http://dx.doi.org/10.1099/jmmcr.0.005080 Text en © 2017 The Authors http://creativecommons.org/licenses/by/4.0/ This is an open access article under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution and reproduction in any medium, provided the original author and source are credited.
spellingShingle Case Report
Adjodah, Chandra
D'Ivernois, Chistophe
Leyssene, David
Berneau, Jean-Baptiste
Hemery, Yann
A cardiac implantable device infection by Raoultella planticola in an immunocompromized patient
title A cardiac implantable device infection by Raoultella planticola in an immunocompromized patient
title_full A cardiac implantable device infection by Raoultella planticola in an immunocompromized patient
title_fullStr A cardiac implantable device infection by Raoultella planticola in an immunocompromized patient
title_full_unstemmed A cardiac implantable device infection by Raoultella planticola in an immunocompromized patient
title_short A cardiac implantable device infection by Raoultella planticola in an immunocompromized patient
title_sort cardiac implantable device infection by raoultella planticola in an immunocompromized patient
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5361635/
https://www.ncbi.nlm.nih.gov/pubmed/28348805
http://dx.doi.org/10.1099/jmmcr.0.005080
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