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Int. J. Mol. Sci. 2016, 17(4), 544; doi:10.3390/ijms17040544

Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis

1
Department of Clinical Pathology and Microbiology, San Gallicano Institute, IRCCS, Rome 00144, Italy
2
Department of Infectious Disease, San Gallicano Institute, IRCCS, Rome 00144, Italy
3
Department of Hematology, Regina Elena National Cancer Institute IRCCS, Rome 00144, Italy
4
Intensive Care Medicine, Regina Elena National Cancer Institute IRCCS, Rome 00144, Italy
5
Department of Biology and Biotechnology “Charles Darwin”, University of Rome Sapienza, Rome 00185, Italy
These authors contributed equally to this work.
*
Author to whom correspondence should be addressed.
Academic Editor: Susanna Esposito
Received: 25 January 2016 / Revised: 2 April 2016 / Accepted: 7 April 2016 / Published: 12 April 2016
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Abstract

Campylobacter jejuni (C. jejuni) bacteremia is difficult to diagnose in individuals with hematological disorders undergoing chemotherapy. The cause can be attributed to the rarity of this infection, to the variable clinical presentation, and to the partial overlapping symptoms underlying the disease. Here, we report a case of a fatal sepsis caused by C. jejuni in a 76-year-old Caucasian man with non-Hodgkin’s lymphoma. After chemotherapeutic treatment, the patient experienced fever associated with severe neutropenia and thrombocytopenia without hemodynamic instability, abdominal pain, and diarrhea. The slow growth of C. jejuni in the blood culture systems and the difficulty in identifying it with conventional biochemical phenotyping methods contributed to the delay of administering a targeted antimicrobial treatment, leading to a fatal outcome. Early recognition and timely intervention are critical for the successful management of C. jejuni infection. Symptoms may be difficult to recognize in immunocompromised patients undergoing chemotherapy. Thus, it is important to increase physician awareness regarding the clinical manifestations of C. jejuni to improve therapeutic efficacy. Moreover, the use of more aggressive empirical antimicrobial treatments with aminoglycosides and/or carbapenems should be considered in immunosuppressed patients, in comparison to those currently indicated in the guidelines for cancer-related infections supporting the use of cephalosporins as monotherapy. View Full-Text
Keywords: Campylobacter jejuni; non-Hodgkin’s lymphoma; chemotherapy; skin lesion Campylobacter jejuni; non-Hodgkin’s lymphoma; chemotherapy; skin lesion
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. (CC BY 4.0).

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Gallo, M.T.; Di Domenico, E.G.; Toma, L.; Marchesi, F.; Pelagalli, L.; Manghisi, N.; Ascenzioni, F.; Prignano, G.; Mengarelli, A.; Ensoli, F. Campylobacter jejuni Fatal Sepsis in a Patient with Non-Hodgkin’s Lymphoma: Case Report and Literature Review of a Difficult Diagnosis. Int. J. Mol. Sci. 2016, 17, 544.

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