Lijuan Lang1, Menglei Wang1, Xiaowen Huang1, Hao Zhou2, Zaigao Zhou1, Liang Huang1, Huanxin Zheng1, Kang Zeng3, Li Li4. 1. Department of Dermatology, Southern Medical University Nanfang Hospital, Guangzhou, 510515, China. 2. Department of Infection Management, Southern Medical University Nanfang Hospital, Guangzhou, 510515, China. 3. Department of Dermatology, Southern Medical University Nanfang Hospital, Guangzhou, 510515, China. nfpfkzk@126.com. 4. Department of Dermatology, Southern Medical University Nanfang Hospital, Guangzhou, 510515, China. npfklily@163.com.
Abstract
BACKGROUND: Chromobacterium violaceum (C. violaceum) is a Gram-negative saprophytic bacterium that is widespread in tropical and subtropical environments, and belongs to conditional pathogenic bacteria. Human infection with C. violaceum is rare, and this can be fatal when the diagnosis and treatment are delayed, especially recurrent infection patients. Since clinicians lack the knowledge for C. violaceum, rapid diagnosis and early appropriate antimicrobial treatment remains challenging. CASE PRESENTATION: A 15-year-old male student was hospitalized for dark abscess, pustules, severe pain in both legs, and fever for 11 days. There were pustules with gray-white pus and red infiltrating plaques on the back, and the subcutaneous nodules could be touched in front of both tibias, with scab, rupture and necrotic tissue of the lower limb. The patient's condition rapidly progressed. Therefore, next-generation sequencing (NGS), pustular secretion and blood culture were concurrently performed. The final diagnosis for this patient was C. violaceum infection by NGS. However, no bacterial or fungal growth was observed in the pustular secretion and blood culture. After 4 weeks of treatment, the patient was discharged from the hospital without any complications associated with C. violaceum infection. CONCLUSION: Rapid diagnosis and early appropriate antimicrobial treatment is the key to the successful treatment of C. violaceum infection, especially in patients with sepsis symptoms. This case highlights that NGS is a promising tool for the rapid diagnosis of C. violaceum infection, preventing the delayed diagnosis and misdiagnosis of C. violaceum infection in patients who tested negative for pustular secretion and blood culture.
BACKGROUND:Chromobacterium violaceum (C. violaceum) is a Gram-negative saprophytic bacterium that is widespread in tropical and subtropical environments, and belongs to conditional pathogenic bacteria. Humaninfection with C. violaceum is rare, and this can be fatal when the diagnosis and treatment are delayed, especially recurrent infectionpatients. Since clinicians lack the knowledge for C. violaceum, rapid diagnosis and early appropriate antimicrobial treatment remains challenging. CASE PRESENTATION: A 15-year-old male student was hospitalized for dark abscess, pustules, severe pain in both legs, and fever for 11 days. There were pustules with gray-white pus and red infiltrating plaques on the back, and the subcutaneous nodules could be touched in front of both tibias, with scab, rupture and necrotic tissue of the lower limb. The patient's condition rapidly progressed. Therefore, next-generation sequencing (NGS), pustular secretion and blood culture were concurrently performed. The final diagnosis for this patient was C. violaceuminfection by NGS. However, no bacterial or fungal growth was observed in the pustular secretion and blood culture. After 4 weeks of treatment, the patient was discharged from the hospital without any complications associated with C. violaceuminfection. CONCLUSION: Rapid diagnosis and early appropriate antimicrobial treatment is the key to the successful treatment of C. violaceuminfection, especially in patients with sepsis symptoms. This case highlights that NGS is a promising tool for the rapid diagnosis of C. violaceuminfection, preventing the delayed diagnosis and misdiagnosis of C. violaceuminfection in patients who tested negative for pustular secretion and blood culture.
Authors: Cristiana F Alves de Brito; Cláudia B Carvalho; Fabrício Santos; Ricardo T Gazzinelli; Sergio C Oliveira; Vasco Azevedo; Santuza M R Teixeira Journal: Genet Mol Res Date: 2004-03-31