Fatal hemorrhagic pneumonia caused by infection due to Kytococcus sedentarius--a pathogen or passenger?
A 55-year old man developed a hemorrhagic pneumonia, likely due to infection with Kytococcus sedentarius during neutropenia following induction chemotherapy for acute myeloid leukemia. Severe mucosal barrier injury and the selective pressure of broad-spectrum antibiotics probably made it possible for this normally harmless commensal to penetrate the gut, spread through the blood stream, and invade the lungs.
Levenga
Henriëtte
H
Department of Oncology, University Medical Center St Radboud, PO Box 9101, 6500 HB Nijmegen, The Netherlands. T.Levenga@onco.umcn.nl
Donnelly
Peter
P
Blijlevens
Nicole
N
Verweij
Paul
P
Shirango
Hebste
H
de Pauw
Ben
B
D000192:Actinomycetales / Q000302:isolation & purification* / Q000472:pathogenicity; D000193:Actinomycetales Infections / Q000209:etiology / Q000382:microbiology*; D000212:Acyclovir / Q000009:adverse effects / Q000627:therapeutic use; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D016470:Bacteremia / Q000209:etiology / Q000382:microbiology; D018988:Bacterial Translocation; D000077723:Cefepime; D002511:Cephalosporins / Q000009:adverse effects / Q000627:therapeutic use; D003015:Clostridium Infections / Q000150:complications; D003091:Colistin / Q000009:adverse effects / Q000627:therapeutic use; D003561:Cytarabine / Q000008:administration & dosage / Q000009:adverse effects; D003630:Daunorubicin / Q000008:administration & dosage / Q000009:adverse effects; D004359:Drug Therapy, Combination / Q000009:adverse effects / Q000627:therapeutic use; D005047:Etoposide / Q000008:administration & dosage / Q000009:adverse effects; D017809:Fatal Outcome; D006469:Hemoptysis / Q000209:etiology*; D006801:Humans; D006918:Hydroxyurea / Q000008:administration & dosage / Q000009:adverse effects; D016867:Immunocompromised Host; D007413:Intestinal Mucosa / Q000187:drug effects / Q000473:pathology; D015470:Leukemia, Myeloid, Acute / Q000150:complications / Q000188:drug therapy; D008297:Male; D008795:Metronidazole / Q000009:adverse effects / Q000627:therapeutic use; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced / Q000150:complications; D018410:Pneumonia, Bacterial / Q000150:complications / Q000382:microbiology*; D015163:Superinfection / Q000209:etiology / Q000382:microbiology*; D017334:Teicoplanin / Q000009:adverse effects / Q000627:therapeutic use; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000009:adverse effects / Q000627:therapeutic use
D002511:Cephalosporins; D003561:Cytarabine; D008795:Metronidazole; D017334:Teicoplanin; D005047:Etoposide; D015662:Trimethoprim, Sulfamethoxazole Drug Combination; D000077723:Cefepime; D000212:Acyclovir; D006918:Hydroxyurea; D003091:Colistin; D003630:Daunorubicin