title: Helicobacter cinaedi bacteremia with cellulitis after ABO-incompatible living-donor liver transplantation: Case report.
abstract: Helicobacter cinaedi (H. cinaedi), a Gram-negative spiral-shaped bacterium, is an enterohepatic non-Helicobacter pylori Helicobacter species. We report the first case of H. cinaedi bacteremia with cellulitis after liver transplantation. A 48-year-old male, who had been a dog breeder for 15 years, underwent ABO-incompatible living-donor liver transplantation for hepatitis C virus-induced decompensated cirrhosis using an anti-hepatitis B core antibody-positive graft. The patient was preoperatively administered rituximab and underwent plasma exchange twice to overcome blood type incompatibility. After discharge, he had been doing well with immunosuppression therapy comprising cyclosporine, mycophenolate mofetil, and steroid according to the ABO-incompatible protocol of our institution. However, 7 mo after transplantation, he was admitted to our hospital with a diagnosis of recurrent cellulitis on the left lower extremity, and H. cinaedi was detected by both blood culture and polymerase chain reaction analysis. Antibiotics improved his symptoms, and he was discharged at day 30 after admission. Clinicians should be more aware of H. cinaedi in immunocompromised patients, such as ABO-incompatible transplant recipients.
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Kohei
authors.initials: K
authors.lastname: Mishima
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Obara
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Kayoko
authors.initials: K
authors.lastname: Sugita
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Shinoda
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Minoru
authors.initials: M
authors.lastname: Kitago
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Yuta
authors.initials: Y
authors.lastname: Abe
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Taizo
authors.initials: T
authors.lastname: Hibi
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Yagi
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Matsubara
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Takehiko
authors.initials: T
authors.lastname: Mori
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Yaoko
authors.initials: Y
authors.lastname: Takano
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Osamu
authors.initials: O
authors.lastname: Itano
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Hasegawa
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Satoshi
authors.initials: S
authors.lastname: Iwata
authors.affiliation: Kohei Mishima, Hideaki Obara, Masahiro Shinoda, Minoru Kitago, Yuta Abe, Taizo Hibi, Hiroshi Yagi, Kentaro Matsubara, Osamu Itano, Yuko Kitagawa, Department of Surgery, Keio University School of Medicine, Tokyo 160-8582, Japan.
authors.forename: Yuko
authors.initials: Y
authors.lastname: Kitagawa
mesh_terms: D000017:ABO Blood-Group System / Q000276:immunology*; D000818:Animals; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D001787:Blood Group Incompatibility / Q000276:immunology*; D002481:Cellulitis / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology*; D004285:Dogs / Q000382:microbiology; D005243:Feces / Q000382:microbiology; D016481:Helicobacter Infections / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology* / Q000635:transmission; D006648:Histocompatibility; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D016031:Liver Transplantation / Q000009:adverse effects* / Q000379:methods; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000175:diagnosis / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology* / Q000635:transmission; D012307:Risk Factors; D016896:Treatment Outcome; D015047:Zoonoses
chemical_list: D000017:ABO Blood-Group System; D000900:Anti-Bacterial Agents; D007166:Immunosuppressive Agents
keywords: ABO-incompatible; Bacteremia; Cellulitis; HBc-Ab-positive donor; Helicobacter cinaedi; Hepatitis C; Liver transplantation; Living-donor