title: Sphingomonas paucimobilis bacteraemia and shock in a patient with rheumatic carditis.
abstract: Acute rheumatic fever (ARF) carditis is treated with steroids, which can cause changes in the cellular immune response, especially decreased CD3 (+) T cells. Nosocomial infections due to steroid use for treatment of ARF carditis or secondary to the changes in the cellular immune response have not been reported in the literature. Sphingomonas paucimobilis is a Gram-negative bacillus causing community- and hospital-acquired infections. It has been reported as causing bacteraemia/sepsis, pneumonia or peritonitis in patients with malignancies, immunosuppression or diabetes. We present a case with S. paucimobilis bacteraemia/sepsis and shock after administration of steroids for treatment of ARF carditis. We suggest early identification of the causative agent and appropriate adjustments of the treatment plan to avoid shock and possible mortality. This is the first reported case of S. paucimobilis bacteraemia/sepsis in the setting of steroid use for ARF carditis.
authors.affiliation: Department of Pediatric Cardiology, Izmir Dr. Behcet Uz Children's Hospital, İzmir, Turkey.
authors.forename: Y
authors.initials: Y
authors.lastname: Yozgat
authors.forename: A
authors.initials: A
authors.lastname: Kilic
authors.forename: C
authors.initials: C
authors.lastname: Karadeniz
authors.forename: R
authors.initials: R
authors.lastname: Ozdemir
authors.forename: O
authors.initials: O
authors.lastname: Doksoz
authors.forename: G
authors.initials: G
authors.lastname: Gulfidan
authors.forename: T
authors.initials: T
authors.lastname: Mese
mesh_terms: D000293:Adolescent; D000893:Anti-Inflammatory Agents / Q000009:adverse effects* / Q000627:therapeutic use; D015703:Antigens, CD / Q000032:analysis; D004452:Echocardiography; D005260:Female; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D016131:Lymphocyte Subsets / Q000276:immunology; D013902:Radiography, Thoracic; D012214:Rheumatic Heart Disease / Q000150:complications* / Q000188:drug therapy; D012772:Shock, Septic / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology*; D020578:Sphingomonas / Q000145:classification / Q000302:isolation & purification*; D013256:Steroids / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000893:Anti-Inflammatory Agents; D015703:Antigens, CD; D013256:Steroids