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JMM Case Rep. 2016 Oct 31;3(5):e005069. doi: 10.1099/jmmcr.0.005069. eCollection 2016 Oct.

Successful treatment of recurrent Helicobacter fennelliae bacteraemia by selective digestive decontamination with kanamycin in a lung cancer patient receiving chemotherapy.

Author information

1
Disease Control and Prevention Center, National Center for Global Health and Medicine , Tokyo , Japan.
2
Department of Microbiology, School of Pharmacy, Aichi Gakuin University , Aichi , Japan.
3
Department of Clinical Laboratory, National Center for Global Health and Medicine , Tokyo , Japan.
4
Respiratory Medicine, National Center for Global Health and Medicine , Tokyo , Japan.

Abstract

INTRODUCTION:

Helicobacter fennelliae is an enterohepatic Helicobacter species causing bacteraemia in immunocompromised hosts. Only a few cases of recurrent H. fennelliae bacteraemia have been reported in Japan and there are no guidelines regarding antimicrobial treatment for H. fennelliae infection.

CASE PRESENTATION:

H. fennelliae bacteraemia was observed in a patient receiving platinum-based chemotherapy for lung cancer. To prevent recurrence, the patient received antibiotic therapy with cefepime, amoxicillin and doxycycline for 6 weeks, which is similar to the therapy for Helicobactercinaedi bacteraemia. Bacteraemia recurred despite the long-term antibiotic therapy. We hypothesized that the H. fennelliae bacteraemia originated from endogenous infection in the intestinal tract due to the long-term damage of the enteric mucosa by platinum-based drugs and performed selective digestive decontamination (SDD) with kanamycin. Bacteraemia did not recur after SDD.

CONCLUSION:

Our observations indicate that clinicians should be aware of possible recurrent H. fennelliae bacteraemia, which could be effectively prevented by SDD with kanamycin.

KEYWORDS:

Helicobacter fennelliae; recurrent bacteremia, lung cancer, chemotherapy; selective digestive decontamination, kanamycin

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