Correspondence
Capnocytophaga sputigena pneumonia and
bacteremia in a patient with diabetes and
gastric cancer
Dear editor,
The pathogens of pneumonia or lung infections are various, however, the pathogens of some patients cannot be iden-tified or very rare.1,2Here, we presented a case with ma-lignancy and diabetes hospitalized with both pneumonia and bacteremia with a rare pathogen.
A 84 years old male with multi-organ disorders, including diapletic seizure, old infarcts at the bilateral basal ganglia, left corona radiata, right thalamus, gastric cancer, type 2 diabetic mellitus, hypertension, and benign prostatic hyperplasia. He just discharged from the hospital due to pneumonia 20 days ago. He presented with chest tightness with fever and for 1 day, and was sent to emergency department of a medical center. After survey at ED, bilateral pneumonia with pleural effusion was diagnosed by chest X-ray with leukocytosis (WBC 18180/ml), thrombocytopenia (Platelet 10,800/ml), and C-reactive protein 55.4 mg/L. Two sets of blood culture collected one from emergency department and one from ward showed Capnocytophaga sputigena, which identified by both matrix-assisted laser desorption/ionizatione time-of-flight mass spectrometry MALTI-TOF (Bruker) and 16S RNA sequencing. However, sputum culture did not grow this pathogen. He was treated with piperacillin/ tazobactam, and the pneumonia improved after treatment.
The C. sputigena is one member of Capnocytophaga spe-cies, which are gram-negative bacilli with facultative, anaerobic, capnophilic characteristics. There are 9 species in genus Capnocytophaga, and the infections caused by these species are frequently related periodontal problem or animal bites. Both immunocompetent and immunocompromised hosts are potential patients infected with these species. This pathogen could cause various types of human infections, including abscesses, bacteremia, chorioamnionitis, empy-ema, endocarditis, osteomyelitis, pleuropneumonitis,
sinusitis, and septic abortion. C. sputigena is known to be present in normal oral flora, which might cause human in-fections, especially among immunocompromised patients.3,4 Capnocytophaga species are found to be susceptible to a large number of antibiotics, of which penicillins, clindamy-cin, macrolides, broad-spectrum cephalosporins, and quino-lones are outstanding examples.5
Figure 1. The initial Chest X-ray of the patient.
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Please cite this article in press as: Lo S-H, et al., Capnocytophaga sputigena pneumonia and bacteremia in a patient with diabetes and gastric cancer, Journal of Microbiology, Immunology and Infection (2017), https://doi.org/10.1016/j.jmii.2017.11.005
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journal homepa ge :www.e-jmii.com Journal of Microbiology, Immunology and Infection (2017) xx, 1e2
https://doi.org/10.1016/j.jmii.2017.11.005
1684-1182/Copyrightª 2017, Taiwan Society of Microbiology. Published by Elsevier Taiwan LLC. This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).
Infections caused by Capnocytophaga species are rare, and species-level biochemical identification is difficult; thus, cases of C. sputigena infection are rarer reported worldwide. Till now, there is no report about C. sputigena related both infection in Taiwan. Herein, we reported the first case with diabetes mellitus and gastric cancer pre-sented with pneumonia and bacteremia by C. sputigena whose clinical condition improved after piperacillin/tazo-bactam treatment (seeFig. 1).
Conflicts of interest
All the authors have nothing to disclose.
Appendix A. Supplementary data
Supplementary data related to this article can be found at
https://doi.org/10.1016/j.jmii.2017.11.005.
References
1.Extensive community-acquired pneumonia with hemophago-cytic syndrome caused by Aeromonas veronii in an immuno-competent patient. J Microbiol Immunol Infect 2017;50: 555e6.
2.Pulmonary empyema caused by co-infections of Mycoplasma pneumoniae and Fusobacterium necrophorum: a rare case of lemierre syndrome. J Microbiol Immunol Infect 2017;50: 557e8.
3.Capnocytophaga sputigena bacteremia in a patient with chronic lymphocytic leukemia. Ann Lab Med 2014;34:325e7.
4.Capnocytophaga sputigena empyema. J Clin Microbiol 2013;51: 2772e4.
5.Bacteremia by multidrug-resistant Capnocytophaga sputigena. J Clin Microbiol 1994;32:1067e9.
Shih-Hao Lo Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan
Yung-Yun Chang Division of General Medicine, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Ya-Ting Jao Infection Control Room, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan Wen-Hung Wang Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan Po-Liang Lu Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan School of Medicine, Graduate Institute of Medicine, Sepsis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Yen-Hsu Chen*
Division of Infectious Diseases, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung Medical University, Kaohsiung, Taiwan School of Medicine, Graduate Institute of Medicine, Sepsis Research Center, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan Department of Biological Science and Technology, College of Biological Science and Technology, National Chiao Tung University, HsinChu, Taiwan
*Corresponding author. E-mail address:[email protected](Y.-H. Chen)
9 October 2017 Available online
-2 Correspondence
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Please cite this article in press as: Lo S-H, et al., Capnocytophaga sputigena pneumonia and bacteremia in a patient with diabetes and gastric cancer, Journal of Microbiology, Immunology and Infection (2017), https://doi.org/10.1016/j.jmii.2017.11.005
