Isolation of Hafnia alvei from bronchoalveolar lavage of an immunocompetent host presenting with cavitating pneumonia: Contaminant or Causative?

IF 1.7 Q3 INFECTIOUS DISEASES GERMS Pub Date : 2023-09-30 eCollection Date: 2023-09-01 DOI:10.18683/germs.2023.1398
Jayleigh Lim, Kenneth Bolger, Brian Canavan
{"title":"Isolation of <i>Hafnia alvei</i> from bronchoalveolar lavage of an immunocompetent host presenting with cavitating pneumonia: Contaminant or Causative?","authors":"Jayleigh Lim, Kenneth Bolger, Brian Canavan","doi":"10.18683/germs.2023.1398","DOIUrl":null,"url":null,"abstract":"<p><strong>Introduction: </strong><i>Hafnia alvei</i> is a Gram-negative, facultative anaerobic bacillus that is most often found as an enteric commensal. It is seldom considered to be pathogenic in immunocompetent individuals.</p><p><strong>Case report: </strong>We describe a case of a 23-year-old, previously healthy male, who presented to the emergency department with a two-day history of hemoptysis, mild dyspnea, pleuritic chest pain, fevers, and chills. Bloods revealed leukocytosis and elevated C-reactive protein. Chest X-ray and CT of the thorax revealed a cavitating lesion in the right upper lobe. He was commenced on empiric antibiotic treatment with amoxicillin/clavulanate and clarithromycin for community-acquired pneumonia in accordance with local guidelines. He subsequently underwent a bronchoscopy, and the bronchoalveolar lavage sample revealed a heavy growth of <i>H. alvei</i>. Despite the widely documented natural resistance of <i>H. alvei</i> to penicillin, the patient demonstrated complete resolution of his symptoms and initial raised inflammatory markers.</p><p><strong>Conclusions: </strong>We present a case of community-acquired cavitary pneumonia in a previously healthy young adult with <i>H. alvei</i> isolated from bronchoalveolar lavage samples. Parallels are drawn between our case and other cases of <i>H. alvei</i> respiratory isolates in our discussion of its clinical significance.</p>","PeriodicalId":45107,"journal":{"name":"GERMS","volume":"13 3","pages":"292-296"},"PeriodicalIF":1.7000,"publicationDate":"2023-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10748838/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"GERMS","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.18683/germs.2023.1398","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2023/9/1 0:00:00","PubModel":"eCollection","JCR":"Q3","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
引用次数: 0

Abstract

Introduction: Hafnia alvei is a Gram-negative, facultative anaerobic bacillus that is most often found as an enteric commensal. It is seldom considered to be pathogenic in immunocompetent individuals.

Case report: We describe a case of a 23-year-old, previously healthy male, who presented to the emergency department with a two-day history of hemoptysis, mild dyspnea, pleuritic chest pain, fevers, and chills. Bloods revealed leukocytosis and elevated C-reactive protein. Chest X-ray and CT of the thorax revealed a cavitating lesion in the right upper lobe. He was commenced on empiric antibiotic treatment with amoxicillin/clavulanate and clarithromycin for community-acquired pneumonia in accordance with local guidelines. He subsequently underwent a bronchoscopy, and the bronchoalveolar lavage sample revealed a heavy growth of H. alvei. Despite the widely documented natural resistance of H. alvei to penicillin, the patient demonstrated complete resolution of his symptoms and initial raised inflammatory markers.

Conclusions: We present a case of community-acquired cavitary pneumonia in a previously healthy young adult with H. alvei isolated from bronchoalveolar lavage samples. Parallels are drawn between our case and other cases of H. alvei respiratory isolates in our discussion of its clinical significance.

查看原文
分享 分享
微信好友 朋友圈 QQ好友 复制链接
本刊更多论文
从一名出现空洞性肺炎的免疫功能正常宿主的支气管肺泡灌洗液中分离出 Hafnia alvei:污染物还是致病菌?
简介Hafnia alvei 是一种革兰氏阴性、兼性厌氧杆菌,最常见于肠道共生菌。在免疫功能正常的个体中,它很少被认为是致病菌:我们描述了一例 23 岁的健康男性病例,他因咯血、轻度呼吸困难、胸膜炎性胸痛、发热和寒战两天后到急诊科就诊。血常规显示白细胞增多和 C 反应蛋白升高。胸部 X 光片和胸部 CT 显示右上叶有空洞性病变。根据当地指南,他开始接受阿莫西林/克拉维酸和克拉霉素的经验性抗生素治疗,以治疗社区获得性肺炎。随后,他接受了支气管镜检查,支气管肺泡灌洗液样本显示有大量白喉杆菌生长。尽管有大量文件证明白喉杆菌对青霉素具有天然抗药性,但患者的症状和最初升高的炎症指标均已完全缓解:我们介绍了一例由支气管肺泡灌洗液样本中分离出的肺泡弧菌引起的社区获得性空洞性肺炎病例。在讨论该病例的临床意义时,我们将该病例与其他从呼吸道分离出的肺泡伊蚊病例进行了比较。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 去求助
来源期刊
GERMS
GERMS INFECTIOUS DISEASES-
CiteScore
2.80
自引率
5.00%
发文量
36
期刊最新文献
Aggregatibacter actinomycetemcomitans endocarditis in an adult patient with patent ductus arteriosus. Clinical spectrum of extrapulmonary non-tuberculous mycobacterial disease in immunocompetent patients: a case series. Clinical, epidemiological and molecular aspects of patients with mpox in Romania. Continuous versus intermittent infusion of beta-lactam antibiotics: where do we stand today? A narrative review. Infective endocarditis by carbapenem-resistant Gram-negative bacteria - a systematic review.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
已复制链接
已复制链接
快去分享给好友吧!
我知道了
×
扫码分享
扫码分享
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1