title: Recurrent Granulibacter bethesdensis infections and chronic granulomatous disease.
abstract: Chronic granulomatous disease (CGD) is characterized by frequent infections, most of which are curable. Granulibacter bethesdensis is an emerging pathogen in patients with CGD that causes fever and necrotizing lymphadenitis. However, unlike typical CGD organisms, this organism can cause relapse after clinical quiescence. To better define whether infections were newly acquired or recrudesced, we use comparative bacterial genomic hybridization to characterize 11 isolates obtained from 5 patients with CGD from North and Central America. Genomic typing showed that 3 patients had recurrent infection months to years after apparent clinical cure. Two patients were infected with the same strain as previously isolated, and 1 was infected with a genetically distinct strain. This organism is multidrug resistant, and therapy required surgery and combination antimicrobial drugs, including long-term ceftriaxone. G. bethesdensis causes necrotizing lymphadenitis in CGD, which may recur or relapse.
authors.affiliation: National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892-1684, USA. degreenberg@niaid.nih.gov
authors.forename: David E
authors.initials: DE
authors.lastname: Greenberg
authors.forename: Adam R
authors.initials: AR
authors.lastname: Shoffner
authors.forename: Adrian M
authors.initials: AM
authors.lastname: Zelazny
authors.forename: Michael E
authors.initials: ME
authors.lastname: Fenster
authors.forename: Kol A
authors.initials: KA
authors.lastname: Zarember
authors.forename: Frida
authors.initials: F
authors.lastname: Stock
authors.forename: Li
authors.initials: L
authors.lastname: Ding
authors.forename: Kimberly R
authors.initials: KR
authors.lastname: Marshall-Batty
authors.forename: Richard L
authors.initials: RL
authors.lastname: Wasserman
authors.forename: David F
authors.initials: DF
authors.lastname: Welch
authors.forename: Kishore
authors.initials: K
authors.lastname: Kanakabandi
authors.forename: Dan E
authors.initials: DE
authors.lastname: Sturdevant
authors.forename: Kimmo
authors.initials: K
authors.lastname: Virtaneva
authors.forename: Stephen F
authors.initials: SF
authors.lastname: Porcella
authors.forename: Patrick R
authors.initials: PR
authors.lastname: Murray
authors.forename: Harry L
authors.initials: HL
authors.lastname: Malech
authors.forename: Steven M
authors.initials: SM
authors.lastname: Holland
mesh_terms: D016947:Acetobacteraceae / Q000145:classification / Q000187:drug effects / Q000235:genetics / Q000302:isolation & purification; D000293:Adolescent; D000328:Adult; D001483:Base Sequence; D021821:Communicable Diseases, Emerging / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D017931:DNA Primers / Q000235:genetics; D016680:Genome, Bacterial; D042822:Genomic Instability; D016905:Gram-Negative Bacterial Infections / Q000150:complications* / Q000175:diagnosis / Q000188:drug therapy / Q000382:microbiology*; D006105:Granulomatous Disease, Chronic / Q000150:complications* / Q000382:microbiology*; D006801:Humans; D008297:Male; D012329:RNA, Bacterial / Q000235:genetics; D012336:RNA, Ribosomal, 16S / Q000235:genetics; D012008:Recurrence
chemical_list: D017931:DNA Primers; D012329:RNA, Bacterial; D012336:RNA, Ribosomal, 16S