Lung abscess secondary to lung cancer with a coinfection of Granulicatellaadiacens and other bacteria: a case report.

BACKGROUND: Granulicatella adiacens is facultative anaerobic Gram-positive bacteria, which mainly involve bacterial endocarditis and bacteremia, but there are few reports of local suppurative infection. A case of lung abscess with a coinfection of Granulicatella adiacens and other bacteria in a lung cancer patient will be reported in this paper. To our knowledge, this is the first case report describing lung abscess due to G.adiacens. CASE PRESENTATION: A 52-year-old Chinese woman was admitted to the hospital, She complained of coughing and expectoration for 1 month, shortness of breath for half a month, and dyspnea for 1 day. After a series of examinations, she was diagnosed with lung abscess, pleural effusion, and bronchogenic carcinoma. Draining pus culture demonstrated Granulicatella adiacens. After more than 5 weeks of antibiotic therapies in total, she gradually recovered to fight against lung cancer. CONCLUSION: This is the first reported lung abscess caused by G.adiacens. In immunosuppressed hosts, G.adiacens is a virulent pathogen associated with a spectrum of intrathoracic suppurative. Earlier diagnosis and proper drainage surgery with effective antibiotics treatment are very important, and antimicrobial treatment should be more than 5 weeks. When complex pulmonary infection interferes with the CT diagnosis, clinical suspicion of lung cancer should be increased if G.adiacens or Eikenella corrodens is detected from a pulmonary infection.

Pediatric acute dacryocystitis due to Eikenella corrodens: A case report.

Eikenella corrodens is a facultatively anaerobic gram-negative rod bacterium in the oropharynx and respiratory tract. It is a member of HACEK (Haemophilus spp., Aggregatibacter spp., Cardiobacterium hominis, E. corrodens, and Kingella kingae) group commonly associated with endocarditis and craniofacial infections. It is usually susceptible to penicillin, second and third-generation cephalosporins, and carbapenem, but has variable susceptibility to first-generation cephalosporin. We herein provide a description of the first case of pediatric acute dacryocystitis caused by E. corrodens. The patient did not respond to oral cephalexin and required surgical drainage followed by intravenous cefotaxime. Also provided is a brief review of the current literature.

Severe purulent pericarditis caused by invasive Eikenella corrodens: case report and literature review.

BACKGROUND: Eikenella corrodens is a slowly growing gram-negative bacillus that can cause severe invasive disease in human. Although E. corrodens infections in various sites of human body have been well described, pericarditis caused by invasive E. corrodens has rarely been reported. CASE PRESENTATION: Here we report the case of a 63-year old male with a complaint of left shoulder pain. The patient was diagnosed as purulent pericarditis by chest computed tomography scan and ultrasound-guided pericardiocentesis, and the pathogen of E. corrodens was identified in the pericardial fluid culture. The clinical condition of the patient deteriorated quickly, and he died right after the drainage surgery even though the pathogen was sensitive to antibiotics treatment. CONCLUSION: E. corrodens is a rare pericarditis associated pathogen. Purulent pericarditis caused by E. corrodens presents atypical manifestations and rapid progression of infection in immunosuppressed individuals such as neutropenic patients. Earlier diagnosis and proper drainage surgery with effective antibiotics treatment may improve the prognosis.

Eikenella corrodens endocarditis and liver abscess in a previously healthy male, a case report.

BACKGROUND: Eikenella corrodens is one of the HACEK bacteria constituting part of the normal flora of the oropharynx, however, still an uncommon pathogen. We report a case of a large Eikenella corrodens liver abscess with simultaneously endocarditis in a previously healthy male. CASE PRESENTATION: A 49-year-old Danish man was admitted because of one-month malaise, fever, cough and unintentional weight loss. On admission there was elevated white blood cell count and C-reactive protein, as well as affected liver function tests. Initially pneumonia was suspected, but due to lack of improvement on pneumonia treatment, a PET-CT scan was performed, which showed a large multiloculated abscess in the liver. The abscess was drained using ultrasound guidance. Culture demonstrated Eikenella corrodens. Transesophageal echocardiography revealed aortic endocarditis. The patient was treated with antibiotics and abscess drainage, on which he slowly improved. He was discharged after 1.5 months of hospitalisation. On follow-up 2 months later, the patient was asymptomatic with normalized biochemistry and ultrasound showed complete regression of the abscess. CONCLUSIONS: This is the first case of documented Eikenella corrodens concurrent liver abscess and endocarditis. The case report highlights that Eikenella corrodens should be considered as a cause of liver abscess. Empirical treatment of pyogenic liver abscess will most often cover Eikenella corrodens, but the recommended treatment is a third generation cephalosporin or a fluoroquinolon. A multiloculated liver abscess may require drainage several times during treatment. The finding of Eikenella corrodens should elicit an echocardiography to diagnose endocarditis even in patients without clinical signs of endocarditis.

Case Report: Iatrogenic Infection from Traditional Treatment of Stingray Envenomation.

A 47-year-old man was stung on the left ankle by a stingray while on vacation on the Island of Bubaque, Guinea-Bissau. The affected limb was initially treated with an attempt to suck out the venom and application of chewed plant root. The following 3 days, local pain gradually diminished, but then high fever erupted together with generalized symptoms and intense pain from the ankle. After initiating antibiotic treatment, the patient was evacuated. Because of sustained symptoms and fever, the wound was surgically debrided, and culture revealed infection with oral flora bacteria. Attempts to suck out venom are not recommended.

Purification and characterization of hemolysin from periodontopathogenic bacterium Eikenella corrodens strain 1073.

Eikenella corrodens 1073 was found to show hemolytic activity when grown on sheep blood agar. A high and dose-dependent hemolytic activity was detected in the cell envelope fraction, which was further purified by ion-exchange and gel-filtration chromatography. Consequently, a 65-kDa protein with hemolytic activity was obtained, suggesting that this protein might be a hemolysin. Its N-terminal amino acid sequence was nearly identical to that of X-prolyl aminopeptidase from E. corrodens ATCC 23834. To confirm that X-prolyl aminopeptidase functions as a hemolytic factor, we expressed the hlyA gene, encoding X-prolyl aminopeptidase, in Escherichia coli. After induction with isopropyl ß-D-1-thiogalactopyranoside, a protein of about 65 kDa was purified on a Ni column, and its hemolytic activity was confirmed. Meanwhile, a strain with a disrupted hlyA gene, which was constructed by homologous recombination, did not show any hemolytic activity. These results suggested that X-prolyl aminopeptidase might function as a hemolysin in E. corrodens.

Corioamnionitis y sepsis neonatal causada por Eikenella corrodens / Chorioamnionitis and neonatal septicaemia due to Eikenella corrodens

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Absceso hepático por Eikenella corrodens / Liver abscess by Eikenella corrodens

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Mouth in Foot Disease.

Toothpicks are commonly used household items that rarely cause serious injury or infection. Toothpick-related injuries often occur due to ingestion with subsequent trauma/infection at distal sites within the gastrointestinal tract; however, cardiovascular, pleural, and soft tissue infections have been reported. Eikenella corrodens is a gram-negative, facultative anaerobic bacillus found in oral flora associated with bite wound infections. A few case reports describe E. corrodens osteomyelitis from toothpick puncture wounds. We report a case of foot cellulitis and abscess in an elderly diabetic after toothpick puncture injury that was unresponsive to empiric antibiotics. Wound cultures grew E. corrodens and rare Peptostreptococcus species. E. corrodens is resistant to first-generation cephalosporins, macrolides, aminoglycosides, clindamycin, and metronidazole. This case highlights the insidious nature of E. corrodens infections and the need to tailor empiric antibiotics for skin and soft tissue infections based on the mechanism of injury. In addition, this case stresses the importance of protective footwear in diabetics and serves as a cautionary tale regarding the use of seemingly innocuous toothpicks.

Aneurisma infeccioso de aorta abdominal infrarrenal por Eikenella corrodens / Aortic abdominal aneurysm infection due to Eikenella corrodens

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Infección por Eikenella corrodens tras mordedura humana / Eikenella corrodens infection after a human bite

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Relapse of polymicrobial endocarditis in an intravenous drug user.

A 26-year-old male intravenous drug user (IDU) presented twice within 6 months with relapsed polymicrobial infective endocarditis (IE) due to Eikenella corrodens and Streptococcus constellatus after completing two courses of appropriate antimicrobial therapy. This report points to relapsing endocarditis as a clinical entity that warrants attention in IDUs when E. corrodens or S. constellatus are causative agents of IE.

Sepsis neonatal por Eikenella corrodens / Neonatal sepsis due to Eikenella corrodens

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Eikenella corrodens in head and neck infections.

BACKGROUND: Eikenella corrodens (E. corrodens) is a Gram-negative facultative anaerobic bacillus that originally was thought to be an attenuated and indigenous bacterium. In recent years, a number of reports have documented that E. corrodens can be a potential pathogen not only in immunocompromised patients but also in hosts with normal immunity. We herein study E. corrodens infections of the head and neck encountered in our department. METHODS: Twenty-two consecutive patients treated in our department for E. corrodens infections of the head and neck were retrospectively analyzed. Microbial specimens were subjected to light microscopic examination, aerobic culture using chocolate and sheep blood agar media, and anaerobic culture using Brucella HK agar medium. Cultured bacteria were subjected to antimicrobial susceptibility tests by means of the broth microdilution method. RESULTS: There were 16 males and 6 females with an average age of 29.9 years. Two patients had malignancy, while the other patients had no particular risk factors or underlying diseases. Infected sites were the ear in 6 cases, pharynx in 12 cases (tonsil in 10 cases), paranasal sinuses in 3 cases, and salivary gland in 1 case. Seventeen patients suffered polymicrobial infections. Staphylococcus and Streptococcus were the most frequently detected pathogens coexisting with E. corrodens, and mixed infections of E. corrodens and Streptococcus milleri group bacteria were prone to form abscesses. Isolated E. corrodens was susceptible to third-generation cephems (MIC90 = 0.15-0.25 microg/ml), carbapenems (MIC90 < or = 0.15 microg/ml), and new quinolones (MIC90 < or = 0.15 microg/ml), and resistant to oxacillin (MIC90 > 8 microg/ml), cefazolin (MIC90 > 4 microg/ml), macrolides (MIC90 = 4-8 microg/ml), and clindamycin (MIC90 > 4 microg/ml). CONCLUSIONS: E. corrodens infections of the head and neck occur most frequently in the tonsil even in hosts with normal immunity. Coexistence with Streptococcus milleri group bacteria and the use of ineffective antibiotics can be exacerbating factors. First-choice drugs for E. corrodens infections should be third-generation cephems, carbapenems, or new quinolones.

Plasmid-mediated genomic recombination at the pilin gene locus enhances the N-acetyl-D-galactosamine-specific haemagglutination activity and the growth rate of Eikenella corrodens.

Eikenella corrodens belongs to a group of periodontopathogenic bacteria and forms unique corroding colonies on solid medium due to twitching motility. It is believed that an N-acetyl-D-galactosamine (GalNAc)-specific lectin on the cell surface contributes significantly to its pathogenicity and can be estimated by its haemagglutination (HA) activity. Recently, a plasmid, pMU1, from strain 1073 has been found; this plasmid affects pilus formation and colony morphology. To identify the gene involved in these phenomena, ORF 4 and ORFs 5-6 on pMU1 were separately subcloned into a shuttle vector, and the resultant plasmids were introduced into E. corrodens 23834. Transformants with the ORF 4 gene, which is identified to be a homologous gene of the type IV pilin gene-specific recombinase, lost their pilus structure and formed non-corroding colonies on a solid medium, whereas transformants with ORFs 5-6 exhibited the same phenotype as the host strain 23834. Southern analysis showed that the introduction of the ORF 4 gene into strain 23834 resulted in genomic recombination at the type IV pilin gene locus. The hybridization pattern of these transformants was similar to that of strain 1073. These results suggest that ORF 4 on pMU1 encodes a site-specific recombinase and causes genomic recombination of the type IV pilin gene locus. Furthermore, the introduction of ORF 4 into strain 23834 increased GalNAc-specific HA activity to a level equivalent to that of strain 1073. Although the morphological colony changes and loss of pilus structure are also observed in phase variation, genomic recombination of the type IV pilin gene locus did not occur in these variants. Moreover, an increase was not observed in the GalNAc-specific HA activity of these variants. These results suggested that the loss of pilus structure, the morphological change in colonies and the increase in HA activity due to plasmid pMU1 might be caused by a mechanism that differs from phase variation, such as a genomic recombination of the type IV pilin gene locus.

Caspase activation is involved in chronic periodontitis.

Periodontitis, a common infectious disease, is initiated by various gram-negative bacteria and characterized by the destruction of the periodontal tissue. Here, we investigated the role of caspases, intracellular proteases that are the key mediators of apoptosis. We show that activation of caspase-3 and caspase-7 is considerably enhanced in gingival tissue from patients with periodontitis. We also demonstrate in in vitro experiments that various periodontopathic bacteria exert a direct growth-suppressing effect and, moreover, can trigger a host-mediated cytotoxic activity involving the CD95 death receptor. Our data suggest that caspase activation is a prominent feature in periodontitis-associated tissue injury.

Amniotic fluid infection syndrome and neonatal mortality caused by Eikenella corrodens.

Different microorganisms not commonly found in the female genital tract have been implicated as causative agents for amniotic fluid infections. Eikenella corrodens is part of the normal flora in the human oral cavity and upper respiratory tract. It is most commonly found in the clinical setting of polymicrobial infections involving human bite wounds, head and neck infections, and periodontitis. On rare occasions, E. corrodens has been reported as a cause of gynecologic infections. There are only 3 reports of documented E. corrodens chorioamnionitis of the placenta resulting in preterm labor, one of which is associated with early neonatal demise. We report a case of preterm delivery of twin infants at 23 weeks of gestation with documented E. corrodens infection in 1 twin who was not resuscitated.

Prevalence of periodontopathic bacteria in aggressive periodontitis patients in a Chilean population.

BACKGROUND: Actinobacillus actinomycetemcomitans is considered a major etiologic agent of aggressive periodontitis (AgP). Other periodontopathic bacteria such as Porphyromonas gingivalis are also suspected of participating in aggressive periodontitis although the evidence to support this is controversial. The aim of the present study was to determine the prevalence of eight periodontopathic bacteria in Chilean patients with AgP. METHODS: Subgingival plaque samples were collected from 36 aggressive, 30 localized, and six generalized periodontitis patients. Samples from 17 advanced chronic periodontitis (CP) patients were taken as controls. Samples collected from the four deepest periodontal pockets in each patient were pooled in prereduced transport fluid (RTF) and cultured. Periodontal bacteria were primarily identified by colony morphology under stereoscopic microscope and rapid biochemical tests. The identity of some bacterial isolates was confirmed by colony polymerase chain reaction (PCR). RESULTS: AgP showed a significatively higher prevalence of C. rectus than CP (P = 0.036). The only statistical difference found was for C. rectus. Patients with AgP showed a higher, but not statistically significant, prevalence of P. gingivalis, E. corrodens, P. micros, and Capnocytophaga sp. A similar prevalence in both groups of patients was observed for F. nucleatum and P. intermedia/nigrescens, and A. actinomycetemcomitans was less prevalent in AgP than CP patients. In localized AgP, P. intermedia/nigrescens, E. corrodens, F. nucleatum, and P. micros were the more prevalent pathogens in contrast to generalized AgP patients who harbored A. actinomycetemcomitans, P. gingivalis, and Capnocytophaga sp. as the most prevalent bacteria. CONCLUSIONS: C. rectus, P. gingivalis, E. corrodens, P. micros, and Capnocytophaga sp. were the most predominant periodontopathic bacteria of AgP in this Chilean population, but the only statistical difference found here between AgP and CP was for C. rectus, suggesting that the differences in clinical appearance may be caused by factors other than the microbiological composition of the subgingival plaque of these patients. In this study, the prevalence of A. actinomycetemcomitans was much lower than that of P. gingivalis.

Absceso cerebral por Eikenella corrodens y Streptococcus intermedius asociado a tumor carcinoide del tubo digestivo / Brain abscess caused by Eikenella corrodens and Streptococcus intermedius associated wit bowel carcinoid tumour

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