Abstract
Introduction: Leptotrichia trevisanii is a large, fusiform, non-sporulating, motile, Gram-negative rod, and is a member of the family Fusobacteriaceae in the phylum Fusobacteria. Although L. trevisanii bacteraemia is extremely rare, severe infections have been reported in immunocompromised patients. Case presentation: We present a case of a 69-year-old woman diagnosed with diffuse large B-cell lymphoma, who suffered a catheter-related bloodstream infection due to L. trevisanii during the post-autologous peripheral blood progenitor-cell transplantation aplasia phase. In this case, rapid identification of the opportunistic pathogen was achieved using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry directly from a blood culture, with correct identification of the micro-organism within 2 h after the blood culture became positive. Conclusion: Rapid identification of this opportunistic pathogen allowed initiation of appropriate antimicrobial therapy, which contributed to a successful clinical outcome for the patient.
Highlights
Leptotrichia trevisanii is a large, fusiform, non-sporulating, motile, Gram-negative rod, and is a member of the family Fusobacteriaceae in the phylum Fusobacteria
Leptotrichia buccalis is the most commonly isolated causative bacterium, six other species have been found to cause infection in humans: Leptotrichia wadei and Leptotrichia hongkongensis have been associated with bacteraemia; Leptotrichia goodfellowii has been isolated in bacteraemia as well as endocarditis and dog bite infection, and Leptotrichia hofstadii and Leptotrichia shahii have been isolated from
We report a case of L. trevisanii catheter-related bacteraemia rapidly identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF matrixassisted laser desorption/ionization time-of-flight mass spectrometry (MS)) in a patient with diffuse large B-cell lymphoma, who underwent peripheral blood stem-cell transplantation (PBSCT), and we review other published cases
Summary
Leptotrichia spp. are fastidious, anaerobic, fusiform, Gramnegative rods that reside in the oral cavity, intestines and female genital tract of humans (Eribe & Olsen, 2008; Liu, 2011). This genus, included in the family Fusobacteriaceae, phylum Fusobacteria, has increasingly been recognized as an opportunistic pathogen in humans, mainly in immunocompromised patients (Couturier et al, 2012). Leptotrichia trevisanii described initially by Tee et al (2001) It has rarely been isolated from human clinical specimens, and when reported it has been associated with bloodstream infections in patients with haematological malignancies (Kumagai et al, 2013). Neither the aerobic bottles obtained from the CVC nor the peripheral blood cultures showed any growth after 5 days of incubation. The MICs obtained were as follows (mg l21): penicillin, 0.016; piperacillin-tazobactam, v0.015; cefotaxime, v0.015; meropenem, 0.02; and vancomicin, 0.016
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