title: Delftia acidovorans bacteremia caused by bacterial translocation after organophosphorus poisoning in an immunocompetent adult patient.
abstract: A 46-year-old woman was transferred to our emergency unit because of impaired consciousness and respiratory failure with the history of excessive pesticide intake. The patient was hypersalivative and had bilateral pupillary miosis. Laboratory results showed markedly decreased cholinesterase. She was intubated and treated in the intensive care unit with the diagnosis of organophosphorus poisoning. The patient had persisted diarrhea, with a high fever and stomach tenderness on day 10. Whole-body contrast enhanced computed tomography revealed a swollen, enhanced small intestinal wall, and blood culture identified Delftia acidovorans. She was diagnosed as D. acidovorans bacteremia, probably caused by bacterial translocation based on the clinical presentation and the exclusion of other sources, and treated well with a total of 8 days of antibiotic therapy. So far as we know, this is the first case of D. acidovorans bacteremia that was presumably caused by bacterial translocation after organophosphorus poisoning in an immunocompetent adult patient.
authors.affiliation: Emergency Unit and Critical Care Center, Tsuyama Central Hospital, 1756 Kawasaki, Tsuyama, Okayama, Japan. e_dai_for_all@hotmail.com
authors.forename: Hideharu
authors.initials: H
authors.lastname: Hagiya
authors.forename: Tomoko
authors.initials: T
authors.lastname: Murase
authors.forename: Junichi
authors.initials: J
authors.lastname: Sugiyama
authors.forename: Yasutoshi
authors.initials: Y
authors.lastname: Kuroe
authors.forename: Hiroyoshi
authors.initials: H
authors.lastname: Nojima
authors.forename: Hiromichi
authors.initials: H
authors.lastname: Naito
authors.forename: Shingo
authors.initials: S
authors.lastname: Hagioka
authors.forename: Naoki
authors.initials: N
authors.lastname: Morimoto
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001285:Atropine / Q000627:therapeutic use; D016470:Bacteremia / Q000382:microbiology*; D018988:Bacterial Translocation; D020605:Delftia acidovorans / Q000187:drug effects / Q000302:isolation & purification / Q000502:physiology*; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000382:microbiology*; D006801:Humans; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D062025:Organophosphate Poisoning
chemical_list: D000900:Anti-Bacterial Agents; D018727:Muscarinic Antagonists; D001285:Atropine