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CASE REPORT
A Case of Helicobacter cinaedi Bacteremia which Determined Antibiotics Treatment Duration after Negative Surveillance Blood Culture in a Hemodialysis Patient
1)Department of General Medicine, Kaga Medical Center, 2)Department of Internal Medicine, Kaga Medical Center, 3)Department of Dermatology, Kaga Medical Center, 4)Department of Bacterial Laboratory, Kaga Medical Center
Kazuhiro OKADA1), Kazuaki MIZUTOMI2), Hiroshi KIMURA3), Akiko NAKANO4), Ayano YOSHIMOTO4) & Hiroo CHIKAZAWA1)
(Received January 21, 2019)
(Accepted May 31, 2019)
Key words: Helicobacter cinaedi, bacteremia, antibiotics treatment duration
Abstract

A 74-year-old man with chronic renal failure on hemodialysis for 8 years, was admitted to our hospital because of fever and chills. Cefcapene pivoxil 300 mg/day was administrated after blood culture was performed, and the fever was relieved immediately. On the third day, gram negative spiral rods were detected in the blood cultures of the first day, so he was hospitalized. Gram staining of the blood cultures revealed the presence of spiral-shaped gram-negative rods. As that pathogen was initially suspected as being Helicobacter cinaedi(H. cinaedi) or Campylobacter fetus(C. fetus), the patient received empiric antibiotic therapy with intravenous meropenem 0.5 g/day, followed by oral amoxicillin 500 mg/day. As he remained afebrile and his CRP levels decreased after antibiotic therapy, he was discharged on the 15th day. MALDI-TOF and PCR identified this spiral-shaped bacteria as H. cinaedi 4 weeks after initiation of therapy, he had negative surveillance of blood cultures and documented clearance of bacteremia. He was treated with 28 days of antimicrobial therapy from clearance of the bacteremia. No recurrences were noted about 9 months until he died from metastatic pancreatic cancer.

[ Kansenshogaku Zasshi 93: 659-662, 2019 ]

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