Campylobacter jejuni fatal sepsis in a patient with non-Hodgkin’s lymphoma: Case report and literature review of a difficult diagnosis

Maria Teresa Gallo, Enea Gino Di Domenico, Luigi Toma, Francesco Marchesi, Lorella Pelagalli, Nicola Manghisi, Fiorentina Ascenzioni, Grazia Prignano, Andrea Mengarelli, Fabrizio Ensoli

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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.

Original languageEnglish
Article number544
JournalInternational Journal of Molecular Sciences
Volume17
Issue number4
DOIs
Publication statusPublished - Apr 12 2016

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Keywords

  • Campylobacter jejuni
  • Chemotherapy
  • Non-Hodgkin’s lymphoma
  • Skin lesion

ASJC Scopus subject areas

  • Physical and Theoretical Chemistry
  • Organic Chemistry
  • Spectroscopy
  • Inorganic Chemistry
  • Catalysis
  • Molecular Biology
  • Computer Science Applications

Cite this

Gallo, M. T., Di Domenico, E. G., Toma, L., Marchesi, F., Pelagalli, L., Manghisi, N., Ascenzioni, F., Prignano, G., Mengarelli, A., & Ensoli, F. (2016). Campylobacter jejuni fatal sepsis in a patient with non-Hodgkin’s lymphoma: Case report and literature review of a difficult diagnosis. International Journal of Molecular Sciences, 17(4), [544]. https://doi.org/10.3390/ijms17040544