Leptotrichia trevisanii: Case Report and Review of the Literature on Patients with Leptotrichia trevisanii Bacteremia in Acute Myeloid Leukemia.

BACKGROUND: Leptotrichia spp. are fastidious facultative anaerobic, pencil-shaped, gramnegative rods that reside in the mouths, intestines, and female genital tracts of humans. Bacteremia and septic shock have been rarely reported in the immunocompromised host. We report a case of L. trevisanii bacteremia in a patient recently diagnosed with acute myeloid leukemia (AML) on chemotherapy. CASE PRESENTATION: A 75-year-old male with a history of diabetes, chronic kidney disease, and coronary artery disease status post-CABG presented with neutropenic fevers and signs of sepsis after the initiation of chemotherapy. Blood cultures were ordered and extensive gene sequencing helped identify Leptotrichia trevisanii as the causative pathogen. Subsequently, the patient was successfully treated with empiric cefepime. DISCUSSION: Opportunistic pathogens are involved in a variety of diseases and have been isolated from immunocompromised patients undergoing transplantation or in patients with comorbidities, like leukemia, lymphoma, or neutropenia. L. trevisanii has been reported as a cause of bloodstream infections in patients with hematologic malignancies receiving chemotherapy. CONCLUSION: This case highlights the key role that Leptotrichia trevisanii plays in the introduction of sepsis among immunocompromised patients, particularly with hematologic malignancies, like AML, on chemotherapy.

Chorioamnionitis due to Leptotrichia trevisanii.

Very long fusiform gram-negative bacilli were observed after Gram staining of amniotic fluid from a 36-year-old multigravida woman. At 24 hours, pure, abundant growth of smooth, gray, only slightly convex catalase-positive and oxidase-negative colonies measuring about 2 mm were observed. Growth was greater in anaerobic than in aerobic conditions. The bacterium was identified as Leptotrichia trevisanii by matrix-assisted laser desorption ionization time of flight mass spectrometry. Ampicillin and gentamicin were prescribed for chorioamnionitis, and vaginal prostaglandins were administered to terminate the pregnancy. The patient remained afebrile throughout 48 hours and was discharged. Microscopic examination of the placenta revealed severe acute chorioamnionitis with a maternal inflammatory response and abundant bacillary-shaped microorganisms. To our knowledge, this isolate constitutes the first reported case of chorioamnionitis caused by L. trevisanii.

Application of chitosan microparticles for treatment of metritis and in vivo evaluation of broad spectrum antimicrobial activity in cow uteri.

Uterine disease such as metritis is associated with multiple bacterial infections in the uteri after parturition. However, treatment of metritis is challenging due to considerably high antibiotic treatment failure rate with unknown reason. Recently, chitosan microparticles (CM) have been developed to exert broad spectrum antimicrobial activity against bacterial pathogens, including multi-drug resistant bacteria, without raising CM resistant mutants. In this study, we tested, using metagenomics analysis, if CM maintain strong antimicrobial activity against pathogenic bacteria such as Fusobacteriaceae and Bacteroidaceae in cow uteri and evaluated CM's potency as an alternative antimicrobial agent to cure metritis in cows. Here, we report that efficacy of CM treatment for metritis was comparable to the antibiotic ceftiofur, and CM greatly altered uterine microflora of sick animals to healthy uterine microflora. Among uterine bacteria, CM significantly decreased Fusobacterium necrophorum, which is known pathogenic bacteria within the uterus. Taken together, we observed the broad spectrum antimicrobial activity of CM in vivo with an animal model, and further evaluated treatment efficacy in cows with metritis, providing insights into promising use of CM as an alternative antimicrobial agent for controlling uterine disease.

Leptotrichia goodfellowii Infection: Case Report and Literature Review.

Leptotrichia is a pencil-shaped Gram-negative rod and is known as an uncommon pathogen of bacteremia in immunocompromised patients. However, because culture and identification of Leptotrichia species is difficult in clinical laboratories, Leptotrichia goodfellowii is grossly underestimated as a human pathogen. In this study, we report a case of L. goodfellowii bacteremia in an immunocompetent patient and review 5 previously reported cases describing infection with L. goodfellowii.

'Leptotrichia amnionii', a newly reported cause of early onset neonatal meningitis.

'Leptotrichia amnionii' is an underestimated fastidious inhabitant of the vaginal flora that can cause upper genital tract infections when predisposing factors are present. We describe here what is believed to be the first reported case of early onset meningitis due to 'L. amnionii' in a neonate with intrauterine growth retardation. The outcome was favourable after cefotaxime treatment.

An emboligenic pulmonary abscess leading to ischemic stroke and secondary brain abscess.

BACKGROUND: Ischemic stroke by septic embolism occurs primarily in the context of infective endocarditis or in patients with a right-to-left shunt and formation of a secondary cerebral abscess is a rare event. Erosion of pulmonary veins by a pulmonary abscess can lead to transcardiac septic embolism but to our knowledge no case of septic embolic ischemic stroke from a pulmonary abscess with secondary transformation into a brain abscess has been reported to date. CASE PRESENTATION: We report the case of a patient with a pulmonary abscess causing a septic embolic cerebral infarction which then transformed into a cerebral abscess. After antibiotic therapy and drainage of the abscess the patient could be rehabilitated and presented an impressive improvement of symptoms. CONCLUSION: Septic embolism should be considered as cause of ischemic stroke in patients with pulmonary abscess and can be followed by formation of a secondary cerebral abscess. Early antibiotic treatment and repeated cranial CT-scans for detection of a secondary abscess should be performed.

Lemierre's syndrome revisited: case report and imaging findings.

Lemierre's syndrome, characterized by infective thrombophlebitis of the internal jugular vein with septic emboli, was once a ubiquitous condition with high mortality rate in the pre-antibiotic era. Radiological literature on this condition has been scanty in the era of cross-sectional imaging. We present a 16-year-old patient with Lemierre's syndrome with discussion of the typical clinical features and CT findings.