title: Relapsing Campylobacter coli bacteremia with reactive arthritis in a patient with X-linked agammaglobulinemia.
abstract: A patient genetically diagnosed with X-linked agammaglobulinemia repeatedly developed bacteremia due to Campylobacter coli (C. coli) for one year and seven months in spite of immunoglobulin replacement therapy. Throughout the clinical course, C. coli with identical genetic patterns was repeatedly isolated from both blood and stool cultures, thus indicating that the patient had latent intestinal infection. The bacteremia was always accompanied by reactive arthritis. Since the immunoglobulin level was extremely low with severe B cell deficiency, the reactive arthritis must have been induced in a humoral immunity-independent manner. Adding oral minocycline following intravenous meropenem was very effective; the stool cultures became negative and the patient has been well for more than one year without relapse of bacteremia.
authors.affiliation: Department of Hematology, Tokyo Madical and Dental University, Tokyo, Japan. ara.hema@tmd.ac.jp <hema@tmd.ac.jp>
authors.forename: Ayako
authors.initials: A
authors.lastname: Arai
authors.forename: Asako
authors.initials: A
authors.lastname: Kitano
authors.forename: Etsuko
authors.initials: E
authors.lastname: Sawabe
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Kanegane
authors.forename: Toshio
authors.initials: T
authors.lastname: Miyawaki
authors.forename: Osamu
authors.initials: O
authors.lastname: Miura
mesh_terms: D000284:Administration, Oral; D000328:Adult; D000361:Agammaglobulinemia / Q000150:complications / Q000235:genetics*; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D016918:Arthritis, Reactive / Q000150:complications / Q000382:microbiology*; D016470:Bacteremia; D002169:Campylobacter Infections / Q000188:drug therapy; D017000:Campylobacter coli / Q000302:isolation & purification; D041321:Chromosomes, Human, X; D005243:Feces / Q000382:microbiology; D008040:Genetic Linkage; D006801:Humans; D007275:Injections, Intravenous; D007410:Intestinal Diseases / Q000188:drug therapy / Q000382:microbiology; D008297:Male; D000077731:Meropenem; D008911:Minocycline / Q000008:administration & dosage / Q000627:therapeutic use; D012008:Recurrence; D013845:Thienamycins / Q000008:administration & dosage / Q000627:therapeutic use; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D013845:Thienamycins; D000077731:Meropenem; D008911:Minocycline