First case of bacteremia caused by Helicobacter cinaedi in a patient with liver cirrhosis: a case report and literature review.
Patients with liver cirrhosis are known to be immunocompromised hosts due to the dysfunction of the cellular and humoral immune systems, allowing easier bacterial translocation from the intestine to the systemic circulation via the portal vein. Sepsis can often be seen in these patients; however, approximately 10 % of patients show negative results with the standard culture period (3-4 days) and their pathogens remain undiagnosed. Here we report the first case of a patient with liver cirrhosis diagnosed with bacteremia due to Helicobacter cinaedi after gastrointestinal symptoms and review 62 cases of H. cinaedi infection in patients with other diseases. The patient showed positive results for H. cinaedi after 10 days of culture. Administration of a carbapenem was effective and clinical symptoms recovered 20 days after admission. H. cinaedi is an enterohepatic bacterial species that causes bacteremia in immunocompromised patients. Due to the difficulty of detection, few cases have been reported to date and to the best of our knowledge, this is the first published case of bacteremia due to H. cinaedi infection in a patient with liver cirrhosis. Since bacteremia in patients with liver cirrhosis can result in fatality, we recommend vigilance for H. cinaedi infection, longer periods of blood culture, polymerase chain reaction analysis, and empirical antibiotic therapy to help improve prognosis.
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan. kenya-k@med.niigata-u.ac.jp.
Kenya
K
Kamimura
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Daisuke
D
Kumaki
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Masashi
M
Arita
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Yuji
Y
Kobayashi
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Ken-Ichi
K
Mizuno
Division of Medical Laboratory, Niigata University Medical and Dental Hospital, Niigata, Japan.
Fumiko
F
Kusama
Division of Medical Laboratory, Niigata University Medical and Dental Hospital, Niigata, Japan.
Megumi
M
Kobayashi
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Hiroyuki
H
Abe
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Yoshifumi
Y
Takahashi
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Kohei
K
Ogawa
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Yoko
Y
Shinagawa
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Manabu
M
Takeuchi
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Yuichi
Y
Sato
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Hirokazu
H
Kawai
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Satoshi
S
Yamagiwa
Division of Gastroenterology and Hepatology, Graduate School of Medical and Dental Sciences, Niigata University, 1-757 Asahimachido-ri, Chuo-ku, Niigata, 951-8510, Japan.
Shuji
S
Terai
D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D016470:Bacteremia / Q000188:drug therapy / Q000382:microbiology*; D015780:Carbapenems / Q000627:therapeutic use; D016998:Helicobacter / Q000302:isolation & purification*; D016481:Helicobacter Infections / Q000175:diagnosis* / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D008103:Liver Cirrhosis / Q000276:immunology*; D008297:Male
D000900:Anti-Bacterial Agents; D015780:Carbapenems
Bacteremia; Helicobacter cinaedi; Liver cirrhosis