Campylobacter jejuni bacteremia and Helicobacter pylori in a patient with X-linked agammaglobulinemia.
We describe a 15-year-old patient with X-linked agammaglobulinemia who developed malabsorption and bacteremia due to infection of Helicobacter pylori and Campylobacter jejuni. The Campylobacter bacteremia was only recognized after subculturing of blood culture bottles that failed to signal in the automated system. After 2 weeks of treatment with meropenem and erythromycin for 4 weeks, the patient developed a relapse of bacteremia 10 months later with a high level erythromycin resistant C. jejuni. Sequencing revealed an A2058C mutation in the 23 S rRNA gene associated with this resistance. Treatment with doxycycline for 4 weeks finally resulted in complete eradication. This case report illustrates the importance for physicians to use adapted culture methods and adequate prolonged therapy in patients with an immunodeficiency. A summary of published case reports and series of patients with hypogammaglobulinemia or agammaglobulinemia with Campylobacter or Helicobacter bacteremia is given.
van den Bruele
T
T
Department of Pediatrics, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
Mourad-Baars
P E C
PE
Claas
E C J
EC
van der Plas
R N
RN
Kuijper
E J
EJ
Bredius
R G M
RG
D000293:Adolescent; D000361:Agammaglobulinemia / Q000150:complications; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000150:complications*; D002169:Campylobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D016123:Campylobacter jejuni / Q000472:pathogenicity; D004318:Doxycycline / Q000627:therapeutic use; D024881:Drug Resistance, Bacterial / Q000235:genetics; D004917:Erythromycin / Q000627:therapeutic use; D040181:Genetic Diseases, X-Linked / Q000150:complications; D016481:Helicobacter Infections / Q000150:complications* / Q000188:drug therapy / Q000382:microbiology; D016480:Helicobacter pylori / Q000472:pathogenicity; D006801:Humans; D016867:Immunocompromised Host; D008286:Malabsorption Syndromes / Q000150:complications; D008297:Male; D000077731:Meropenem; D009154:Mutation; D012008:Recurrence; D013845:Thienamycins / Q000627:therapeutic use
D000900:Anti-Bacterial Agents; D013845:Thienamycins; D004917:Erythromycin; D000077731:Meropenem; D004318:Doxycycline