Bacteraemia caused by Clostridium baratii and Kawasaki syndrome. First case report
Abstract number: r2256
Iaria C., Stassi G., Arena A., Costa G.B., La Mazza A., Silipigni L., Salpietro D.C., Cascio A.
The clinical spectrum of clostridial bacteraemia ranges from an asymptomatic patient having an incidental positive blood culture to a full-blown, life-threatening infection. Kawasaki syndrome is an acute, self-limited systemic vasculitis of unknown aetiology that occurs in children. Its importance is due to the coronary artery aneurysms that develop in 2025% of cases if the treatment is not given early in the course of the disease.
A 3-year-old male presented for evaluation of fever, abdominal pain, vomiting and polymorphous erythematosus rash on the extremities of 3 days duration. Three weeks before he presented with irregular fever and micropapulous exanthema over the truncus for 3 days followed after two days by perianal hyperaemia, scrotal oedema and balanopreputial hyperaemia and swelling. On admission, he was febrile (38.5°C). Physical examination showed: periungual peeling on the palms and fingers; severe hyperaemia of perianal region with peeling areas; erythematosus pharynx, strawberry tongue, dry and fissured lips, angular cheilitis; unilateral enlarged jugulodigastric nodes. Laboratory examinations revealed a white blood cell count of 5000/mL with 54% neutrophils and 38% lymphocytes. Platelet count 222.000/mL, C-reactive protein concentration of 50 mg/l and an erythrocyte sedimentation rate of 27 mm/h, serum IgA 297 mg/dl. Within the normal range anti-streptolysin O, IgM, IgG, blood urea, glycaemia, creatinine, plasma bilirubin, transaminases, gamma-glutamyltransferase, CD4+T-cells, CD8+ T-cells, CD19, NK cells, CD4/CD8 rate. No reactive for EBV, CMV, HSV-1, HSV-2, VZV, Adenovirus, Parvovirus B19, Coxsackie, Echovirus and Chlamydia pneumoniae. Results of urine analysis showed sterile pyuria. Two blood cultures were processed by the hospital microbiology laboratory using a standard blood culturing system (BACTEC 9120; Becton Dickinson). The anaerobic bottles gave a positive result at day 3 after inoculation. The biochemical profiles produced by the RapID ANA II System (Remel, Inc., Lenexa, KS) showed that the organism was Clostridium baratii with a probability of 99%.
Our report highlights the importance of C. baratii as a potential human pathogen and documents the association with symptoms never before reported in clostridial infections.
|Session name:||XXIst ISTH Congress|
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