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Case Report

Actinotignum schaalii Pyelonephritis in a Young Adult with Ureteric Calculus: Case Report

by
Jayaweera Arachchige Asela Sampath Jayaweera
1,* and
Gerard Ranasinghe
2
1
Department of Microbiology, Faculty of Medicine and Allied Sciences Rajarata University of Sri Lanka Saliyapura 50008, Sri Lanka
2
Teaching Hospital, Kurunegala 40000, Sri Lanka
*
Author to whom correspondence should be addressed.
GERMS 2024, 14(1), 101-104; https://doi.org/10.18683/germs.2024.1422
Submission received: 10 December 2023 / Revised: 13 February 2024 / Accepted: 28 February 2024 / Published: 31 March 2024

Abstract

Introduction: Actinotignum schaalii is a Gram-positive coccobacillus, and a member of the normal human microbiota. A. schaalii is considered as an emerging pathogen causing urinary tract infections among the elderly. Because of an anaerobic growth requirement and lack of knowledge on pathogenic potential following conventional microbiology laboratory techniques, A. schaalii is difficult to identify. Case report: A previously well 24-year-old male presented to a tertiary care unit with fever, left flank pain, and dysuria for two days. He was initially treated with empiric oral ciprofloxacin by the general practitioner. Following admission, blood cultures and urine cultures were done, and empirical intra-venous piperacillin-tazobactam was started. X-ray of the pelvis revealed left-sided pyelonephritis and left ureteric calculi. A nephrostomy tube was inserted to relieve the obstruction which drained pus and was sent to microbiology laboratory in aerobic and anaerobic blood culture bottles. Two days later blood culture flagged positive for Gram-positive bacilli from the anaerobic bottle, and the pus from enriched anaerobic culture grew A. schaalii. The urine culture remained negative. By VITEK 2 anaerobic card and MALDI-TOF analysis, it was identified as A. schaalii. Following clinical improvement, he was discharged with oral doxycycline. Ureteric calculus was removed and remained sterile following 16s DNA analysis. Conclusions: The urine Gram staining may have a role in detecting and considering anaerobic media to isolate A. schaalii. The novel diagnostic platforms are important to speciate the pathogen. Also, the lack of pathogen-specific breakpoints for antimicrobial susceptibilities made it a problem to decide on appropriate therapy.
Keywords: Actinotignum schaalii; anaerobic; urinary tract infections; elderly; emerging infection Actinotignum schaalii; anaerobic; urinary tract infections; elderly; emerging infection

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MDPI and ACS Style

Jayaweera, J.A.A.S.; Ranasinghe, G. Actinotignum schaalii Pyelonephritis in a Young Adult with Ureteric Calculus: Case Report. GERMS 2024, 14, 101-104. https://doi.org/10.18683/germs.2024.1422

AMA Style

Jayaweera JAAS, Ranasinghe G. Actinotignum schaalii Pyelonephritis in a Young Adult with Ureteric Calculus: Case Report. GERMS. 2024; 14(1):101-104. https://doi.org/10.18683/germs.2024.1422

Chicago/Turabian Style

Jayaweera, Jayaweera Arachchige Asela Sampath, and Gerard Ranasinghe. 2024. "Actinotignum schaalii Pyelonephritis in a Young Adult with Ureteric Calculus: Case Report" GERMS 14, no. 1: 101-104. https://doi.org/10.18683/germs.2024.1422

APA Style

Jayaweera, J. A. A. S., & Ranasinghe, G. (2024). Actinotignum schaalii Pyelonephritis in a Young Adult with Ureteric Calculus: Case Report. GERMS, 14(1), 101-104. https://doi.org/10.18683/germs.2024.1422

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