Abstract
BackgroundLung transplant recipients have an increased risk for actinomycetales infection secondary to immunosuppressive regimen.Case presentationA case of pulmonary infection with bacteremia due to Tsukamurella tyrosinosolvens in a 54-year old man who underwent a double lung transplantation four years previously is presented.ConclusionThe identification by conventional biochemical assays was unsuccessful and hsp gene sequencing was used to identify Tsukamurella tyrosinosolvens.
Highlights
Lung transplant recipients have an increased risk for actinomycetales infection secondary to immunosuppressive regimen.Case presentation: A case of pulmonary infection with bacteremia due to Tsukamurella tyrosinosolvens in a 54-year old man who underwent a double lung transplantation four years previously is presented
Phylogenetic analyses have demonstrated that the genus Tsukamurella is related to the genera Nocardia, Rhodococcus, Dietzia, Gordonia, Streptomyces, Corynebacterium and Mycobacterium [1,2]
In all of the cases, this bacterium was isolated in immunocompromized patients with gastric cancer [14] or chronic pulmonary infections [6] and in patients who were carriers of cardiac implants or intravascular catheters [15,16,17]
Summary
Bacteria of the genus Tsukamurella are included in the order Actinomycetales, characterized by mycolic acids. The name of Tsukamurella comes from Tsukamura, a microbiologist who in 1971 described the first strain of Gordona aurantiaca, isolated from sputum of a patient who was affected by a chronic lung pathology [3]. We describe the first isolation of T. tyrosinosolvens from sputum and blood samples of a lung transplant patient. A 54-year old man was hospitalized in July 2008 for a pulmonary infection. His medical history indicated 1) a lung transplant in November 2004 for emphysema linked to an alpha-1-antitrypsin deficiency, 2) chronic respiratory insufficiency, and 3) hypertension. Blood culture showed only Gram-positive bacilli from the three aerobic bottles after 5 days which were identical to those identified in the broncho-alveolar fluid grown at the same time. The evolution was favorable with an important decrease in the inflammatory syndrome, the C-reactive proteins decreased from 103 to 9.3 mg/L
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