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Burkholderia cepacia Sepsis in a Previously Healthy Full-Term Infant

Burkholderia cepacia causes sepsis in neonates who are immunocompromised or exposed via nosocomial transmission. We report a case of B. cepacia sepsis in a previously healthy 5-week-old male originally treated for bacterial pneumonia per chest X-ray findings and 3 days of fevers. Regardless of appro...

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Autores principales: Carmona, Carlos A., Marante, Alberto, Levent, Fatma, Marsicek, Sarah
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556054/
https://www.ncbi.nlm.nih.gov/pubmed/33083079
http://dx.doi.org/10.1155/2020/8852847
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author Carmona, Carlos A.
Marante, Alberto
Levent, Fatma
Marsicek, Sarah
author_facet Carmona, Carlos A.
Marante, Alberto
Levent, Fatma
Marsicek, Sarah
author_sort Carmona, Carlos A.
collection PubMed
description Burkholderia cepacia causes sepsis in neonates who are immunocompromised or exposed via nosocomial transmission. We report a case of B. cepacia sepsis in a previously healthy 5-week-old male originally treated for bacterial pneumonia per chest X-ray findings and 3 days of fevers. Regardless of appropriate antibiotics and an initial negative blood culture, he developed severe hypoglycemia, circulatory collapse with disseminated intravascular coagulopathy, and expired. A second blood culture taken following transfer to the intensive care unit resulted positive for B. cepacia postmortem. Review of the newborn screen and family history was otherwise normal. Subsequent postmortem autopsy showed multifocal bilateral pneumonia with necrotizing granulomatous and suppurative portions of lung tissue. Additionally, there was a prominent cavitary lesion 2.5 cm in the right lower lobe with branching and septate fungal hyphae. Stellate microabscesses with granulomas were present in the liver and spleen. These findings plus B. cepacia bacteremia are highly suggestive of an immunocompromised status. Review of the literature shows that its presence has been associated with chronic granulomatous disease. Therefore, in a persistently febrile infant not responding to antibiotics for common microbes causing community-acquired pneumonia, immunodeficiency workup should ensue in addition to respective testing for chronic granulomatous disease especially if B. cepacia culture-positive as it is strongly associated with neutrophil dysfunction.
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spelling pubmed-75560542020-10-19 Burkholderia cepacia Sepsis in a Previously Healthy Full-Term Infant Carmona, Carlos A. Marante, Alberto Levent, Fatma Marsicek, Sarah Case Rep Pediatr Case Report Burkholderia cepacia causes sepsis in neonates who are immunocompromised or exposed via nosocomial transmission. We report a case of B. cepacia sepsis in a previously healthy 5-week-old male originally treated for bacterial pneumonia per chest X-ray findings and 3 days of fevers. Regardless of appropriate antibiotics and an initial negative blood culture, he developed severe hypoglycemia, circulatory collapse with disseminated intravascular coagulopathy, and expired. A second blood culture taken following transfer to the intensive care unit resulted positive for B. cepacia postmortem. Review of the newborn screen and family history was otherwise normal. Subsequent postmortem autopsy showed multifocal bilateral pneumonia with necrotizing granulomatous and suppurative portions of lung tissue. Additionally, there was a prominent cavitary lesion 2.5 cm in the right lower lobe with branching and septate fungal hyphae. Stellate microabscesses with granulomas were present in the liver and spleen. These findings plus B. cepacia bacteremia are highly suggestive of an immunocompromised status. Review of the literature shows that its presence has been associated with chronic granulomatous disease. Therefore, in a persistently febrile infant not responding to antibiotics for common microbes causing community-acquired pneumonia, immunodeficiency workup should ensue in addition to respective testing for chronic granulomatous disease especially if B. cepacia culture-positive as it is strongly associated with neutrophil dysfunction. Hindawi 2020-10-05 /pmc/articles/PMC7556054/ /pubmed/33083079 http://dx.doi.org/10.1155/2020/8852847 Text en Copyright © 2020 Carlos A. Carmona Jr. et al. https://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Case Report
Carmona, Carlos A.
Marante, Alberto
Levent, Fatma
Marsicek, Sarah
Burkholderia cepacia Sepsis in a Previously Healthy Full-Term Infant
title Burkholderia cepacia Sepsis in a Previously Healthy Full-Term Infant
title_full Burkholderia cepacia Sepsis in a Previously Healthy Full-Term Infant
title_fullStr Burkholderia cepacia Sepsis in a Previously Healthy Full-Term Infant
title_full_unstemmed Burkholderia cepacia Sepsis in a Previously Healthy Full-Term Infant
title_short Burkholderia cepacia Sepsis in a Previously Healthy Full-Term Infant
title_sort burkholderia cepacia sepsis in a previously healthy full-term infant
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7556054/
https://www.ncbi.nlm.nih.gov/pubmed/33083079
http://dx.doi.org/10.1155/2020/8852847
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