title: A new emerging oral infection: Raoultella planticola in a boy with haematological malignancy.
abstract: BACKGROUND
  Oral mucositis is a common complication in pediatric cancer patients, affecting up to 80% of children. Due to neutropenia and disruption of the mucosal barrier, chemotherapy-induced oral mucositis is often complicated by super-infections.
  
  
  METHODS
  A 16-years old male with stage 3 Burkitt's lymphoma developed chemotherapy induced oral mucositis grade 3 (according to WHO scale). Ulcers were quickly growing (reaching a maximum diameter of 3 cm) and became greyish in colour, resulting in dysphagia and pain. A swab of the lesions was taken and microbiological tests were performed. The sample grew for Raoultella planticola, an encapsulated Gram-negative bacterium whose full pathogenic potential still needs to be defined.
  
  
  METHODS
  The patient received antibiotic combination therapy with Amikacin and Ceftazidime for 8 days. Complete healing of the lesions and resolution of the symptoms were reached and he completed his antineoplastic therapy without further complications.
  
  
  RESULTS
  Twelve months after the infection, he is alive and well, with no oral complaints.
  
  
  CONCLUSIONS
  This is the first report of a Raoultella planticola infection in a patient with chemotherapy induced oral mucositis. This type of infection must be added to the list of organisms to be considered when caring for these patients.
authors.affiliation: Department Oral Medicine and Paediatric Dentistry, Dental Clinic, University of Brescia, p.le Spedali Civili n.1, 25133, Brescia, Italy. elena.bardellini@unibs.it.
authors.forename: E
authors.initials: E
authors.lastname: Bardellini
authors.affiliation: Department Oral Medicine and Paediatric Dentistry, Dental Clinic, University of Brescia, p.le Spedali Civili n.1, 25133, Brescia, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Amadori
authors.affiliation: Paediatric Haematology-Oncology Unit, Spedali Civili di Brescia, Brescia, Italy.
authors.forename: R F
authors.initials: RF
authors.lastname: Schumacher
authors.affiliation: Microbiology Department, Spedali Civili di Brescia, Brescia, Italy.
authors.forename: I
authors.initials: I
authors.lastname: Foresti
authors.affiliation: Department Oral Medicine and Paediatric Dentistry, Dental Clinic, University of Brescia, p.le Spedali Civili n.1, 25133, Brescia, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Majorana
mesh_terms: D000293:Adolescent; D000583:Amikacin / Q000008:administration & dosage / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000008:administration & dosage / Q000627:therapeutic use; D002051:Burkitt Lymphoma / Q000150:complications*; D002442:Ceftazidime / Q000008:administration & dosage / Q000627:therapeutic use; D004359:Drug Therapy, Combination; D004755:Enterobacteriaceae; D004756:Enterobacteriaceae Infections / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology; D006801:Humans; D008297:Male; D013280:Stomatitis / Q000188:drug therapy / Q000209:etiology* / Q000382:microbiology
chemical_list: D000900:Anti-Bacterial Agents; D000583:Amikacin; D002442:Ceftazidime
keywords: Anti-neoplastic agents; Infection; Oral ulcer