Leptotrichia buccalis bacteremia in two patients with acute myelogenous leukemia

ABSTRACT

Leptotrichia buccalis is the type species of genus Leptotrichia. In spite of the common existence in humans as normal oral flora, it is rarely implicated in systemic disease. We report 2 recent patients with clinically significant L. buccalis bacteremia which developed during the neutropenia secondary to chemotherapy, and was associated with non-specific high grade febrile illness. Gram stain appearance was characteristic and identification by routine phenotypic methods and cellular fatty acid analysis was possible. Both patients were treated successfully with metronidazole or clindamycin. Based on our experience and literature review, anaerobic Gram negative bacteremia should be considered in certain high risk immunocompromised patients with mucositis and/or gingivitis and early appropriate therapy should be initiated