[Necrotizing pneumonia due to Gemella morbillorum in an immunocompetent patient].
BACKGROUND
Gemella morbillorum is an anaerobic to aerotolerant Gram positive coccus. It is considered a member of the normal upper respiratory tract flora including the oropharynx and also the gastro-intestinal and female genital tract. However severe infections are reported like endocarditis, septic shock and septic arthritis, more often in immunocompromised hosts. It is an infrequently isolated organism and a rare cause of pulmonary or pleural infections.


METHODS
We report a case of necrotizing pneumonia due to Gemella morbillorum in a 45-years-old Melanesian, smoker patient. The presentation was subacute with a four month history of loss of appetite, progressive weight loss and cough without fever. Initial presentation seems to be a malignant disease. The positive diagnosis has been established on the results of BAL fluid and the protected specimen brush samples. It was an immunocompetent patient presenting dental inflammation but not oral infection. Further management included intravenous administration of amoxicillin during two weeks. We recommended oral antibiotic treatment for another six weeks. After two months the patient was reevaluated. The CT scan showed no evidence of persistent infection. The HR CT scan will reveal multiple kystic bronchiectasies not seen on the first CT scan.


CONCLUSIONS
Gm can be found endoscopic samples. Gemella morbillorum can be responsible of community-acquired pneumonia in immunocompetent host.
Estivals
M
M
Service de Pneumologie, CHT G Bourret, Nouméa, Nouvelle Calédonie. m.estivals@cht.nc
Mermond
S
S
Barbe
C
C
du Couëdic
L
L
du Covedic
L
L
Birolleau
S
S
Levenes
H
H
D006801:Humans; D016867:Immunocompromised Host; D008168:Lung / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000382:microbiology; D011023:Pneumonia, Staphylococcal / Q000175:diagnosis*; D012907:Smoking / Q000009:adverse effects; D040141:Staphylococcaceae / Q000472:pathogenicity*