Recurrent bacteremia caused by a "Flexispira"-like organism in a patient with X-linked (Bruton's) agammaglobulinemia.
Helicobacter spp., except for Helicobacter cinaedi, have only rarely been reported in cases of septicemia. A patient with X-linked (Bruton's) agammaglobulinemia was found to have persistent sepsis with a Helicobacter-like organism despite multiple courses of antibiotics. His periods of sepsis were associated with leg swelling thought to be consistent with cellulitis. The organism was fastidious and required a microaerophilic environment containing H(2) for growth. Optimal growth was observed at 35 to 37 degrees C on sheep blood, CDC anaerobe, and Bordet-Gengou agars. Serial subcultures every 4 to 5 days were required to maintain viability. The organism was strongly urease positive and showed highest relatedness to Helicobacter-like organisms with the vernacular name "Flexispira rappini" by 16S rRNA gene sequence analysis. Genomic DNA hybridization studies, however, found 24 to 37% relatedness to "F. rappini" and even less to other Helicobacter spp. Although the organism phenotypically resembles "Flexispira" and Helicobacter, it is thought to represent a new taxon. The patient's infection was eventually cleared with a prolonged (5-month) course of intravenous imipenem and gentamicin.
Microbiology Service, Clinical Pathology Department, W.G. Magnuson Clinical Center, National Institutes of Health, Bethesda, Maryland 20892, USA.
S
S
Weir
B
B
Cuccherini
A M
AM
Whitney
M L
ML
Ray
J P
JP
MacGregor
A
A
Steigerwalt
M I
MI
Daneshvar
R
R
Weyant
B
B
Wray
J
J
Steele
W
W
Strober
V J
VJ
Gill
D000328:Adult; D000361:Agammaglobulinemia / Q000150:complications* / Q000235:genetics; D016470:Bacteremia / Q000209:etiology / Q000382:microbiology*; D008040:Genetic Linkage; D016998:Helicobacter / Q000235:genetics / Q000302:isolation & purification*; D016481:Helicobacter Infections / Q000209:etiology / Q000382:microbiology*; D006801:Humans; D008297:Male; D010802:Phylogeny; D012008:Recurrence; D014960:X Chromosome