BACKGROUND: Aerococcus viridans organisms are gram-positive, usually airborne cocci that are widely distributed in hospital environments. These bacteria have infrequently been encountered as a human pathogen causing bacteremia, endocarditis and urinary tract infections. The clinical significance of these bacteria may be overlooked due to their fastidious growth and often confused with other strains of streptococci. CASE REPORT: We report a case of urinary tract infection with bacteremia caused by A. viridans in an 87 year-old male nursing home resident. The patient presented with a fever of 103 degrees F, dysuria, hematuria and weakness for three days. Urinalysis showed large amount of blood, more than one hundred white cells/HPF and 4+ bacteria. Laboratory tests revealed, white blood cell count of 2300/cu mm (neutrophils 80%, bands 7%, lymphocytes 11% and monocytes 2%), hemoglobin 15.4 gm/dL, blood urea nitrogen 23 mg/dL and creatinine 1.2 mg/dL. Urine culture yielded growth of 10(5) CFU of A. viridans. The patient was treated for ten days with levofloxacin (both IV + PO). CONCLUSIONS: To date, no clinical case report of this nature has been described implicating A. viridans in urinary tract infections. Increased awareness and more studies of this genus should lead to the identification of their potential role in human infections.
BACKGROUND:Aerococcus viridans organisms are gram-positive, usually airborne cocci that are widely distributed in hospital environments. These bacteria have infrequently been encountered as a human pathogen causing bacteremia, endocarditis and urinary tract infections. The clinical significance of these bacteria may be overlooked due to their fastidious growth and often confused with other strains of streptococci. CASE REPORT: We report a case of urinary tract infection with bacteremia caused by A. viridans in an 87 year-old male nursing home resident. The patient presented with a fever of 103 degrees F, dysuria, hematuria and weakness for three days. Urinalysis showed large amount of blood, more than one hundred white cells/HPF and 4+ bacteria. Laboratory tests revealed, white blood cell count of 2300/cu mm (neutrophils 80%, bands 7%, lymphocytes 11% and monocytes 2%), hemoglobin 15.4 gm/dL, blood ureanitrogen 23 mg/dL and creatinine 1.2 mg/dL. Urine culture yielded growth of 10(5) CFU of A. viridans. The patient was treated for ten days with levofloxacin (both IV + PO). CONCLUSIONS: To date, no clinical case report of this nature has been described implicating A. viridans in urinary tract infections. Increased awareness and more studies of this genus should lead to the identification of their potential role in human infections.
Authors: V Martín; A I Vela; M Gilbert; J Cebolla; J Goyache; L Domínguez; J F Fernández-Garayzábal Journal: J Clin Microbiol Date: 2007-06-27 Impact factor: 5.948