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Klenk C, Schnieders M, Heinemann M, Wiegard C, Büttner H, Ramharter M, Jordan S, Mackroth MS. Severe Systemic Chromobacterium violaceum Infection: A Case Study of a German Long-Term Resident in French Guyana. Trop Med Infect Dis 2024; 9:242. [PMID: 39453269 PMCID: PMC11511043 DOI: 10.3390/tropicalmed9100242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2024] [Revised: 10/08/2024] [Accepted: 10/10/2024] [Indexed: 10/26/2024] Open
Abstract
Chromobacterium violaceum is a Gram-negative, facultative anaerobe proteobacterium. Its natural habitat is water and soil in tropical and subtropical regions. Human infections are characterized by rapid dissemination that can lead to high fatality rates. Here, we describe the first case of a C. violaceum infection reported from Germany. A German national with permanent residence in French Guyana contracted a C. violaceum infection presumably while bathing in a barrier lake in Brazil. The patient presented with a high fever and a crusty, erythematous skin lesion at an emergency department in Hamburg, Germany. Ultrasound and a CT scan of the abdomen revealed multiple liver abscesses. C. violaceum was detected in blood and from aspirates of the liver abscesses, using traditional culture methods and modern molecular assays. Prolonged treatment with meropenem and ciprofloxacin led to full recovery. Rapid pathogen detection and treatment initiation are of high importance in C. violaceum infections as mortality rates are overall declining but have still tended to reach up to 25% in recent years in systemic infections. Due to its broad natural drug resistance, antibiotic treatment is challenging. Increased travel activities may lead to more frequent presentation of patients with environmental pathogens of the tropics such as C. violaceum.
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Affiliation(s)
- Caroline Klenk
- I. Medical Department, Division of Tropical Medicine, University Medical Centre Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; (C.K.); (M.S.); (M.R.); (S.J.)
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany;
| | - Miriam Schnieders
- I. Medical Department, Division of Tropical Medicine, University Medical Centre Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; (C.K.); (M.S.); (M.R.); (S.J.)
| | - Melina Heinemann
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany;
- I. Medical Department, Division of Infectious Diseases, University Medical Centre Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Christiane Wiegard
- I. Medical Department, Ultrasound Unit, University Medical Centre Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany;
| | - Henning Büttner
- Department of Medical Microbiology, University Medical Centre Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany;
| | - Michael Ramharter
- I. Medical Department, Division of Tropical Medicine, University Medical Centre Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; (C.K.); (M.S.); (M.R.); (S.J.)
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany;
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel, Inhoffenstr. 7, 38124 Braunschweig, Germany
| | - Sabine Jordan
- I. Medical Department, Division of Tropical Medicine, University Medical Centre Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany; (C.K.); (M.S.); (M.R.); (S.J.)
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany;
- I. Medical Department, Division of Infectious Diseases, University Medical Centre Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
| | - Maria Sophia Mackroth
- Department of Tropical Medicine, Bernhard Nocht Institute for Tropical Medicine, Hamburg, Bernhard-Nocht-Strasse 74, 20359 Hamburg, Germany;
- I. Medical Department, Division of Infectious Diseases, University Medical Centre Hamburg Eppendorf, Martinistr. 52, 20246 Hamburg, Germany
- German Centre for Infection Research (DZIF), Partner Site Hamburg-Luebeck-Borstel, Inhoffenstr. 7, 38124 Braunschweig, Germany
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Wang X, Tu Y, Chen Y, Yang H, Luo M, Li Y, Huang L, Luo H. Critical bloodstream infection caused by Chromobacterium violaceum: a case report in a 15-year-old male with sepsis-induced cardiogenic shock and purpura fulminans. Front Med (Lausanne) 2024; 11:1342706. [PMID: 38596787 PMCID: PMC11002164 DOI: 10.3389/fmed.2024.1342706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 03/01/2024] [Indexed: 04/11/2024] Open
Abstract
Chromobacterium violaceum (C. violaceum) is a gram-negative bacillus that is widespread in tropical and subtropical areas. Although C. violaceum rarely infects humans, it can cause critical illness with a mortality rate above 50%. Here, we report the successful treatment of a 15-year-old male who presented with bloodstream infection of C. violaceum along with sepsis, specific skin lesions, and liver abscesses. Cardiogenic shock induced by sepsis was reversed by venoarterial extracorporeal membrane oxygenation (VA ECMO). Moreover, C. violaceum-related purpura fulminans, which is reported herein for the first time, was ameliorated after treatment. This case report demonstrates the virulence of C. violaceum with the aim of raising clinical awareness of this disease.
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Affiliation(s)
- Xueqing Wang
- Department of Intensive Care Unit (ICU), Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Yunliang Tu
- Department of Intensive Care Unit (ICU), Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Yingqun Chen
- Department of Intensive Care Unit (ICU), Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Huilin Yang
- Department of Microbiology Laboratory, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Minghua Luo
- Department of Pathology, Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Yanyan Li
- Department of Intensive Care Unit (ICU), Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Lei Huang
- Department of Intensive Care Unit (ICU), Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Hua Luo
- Department of Intensive Care Unit (ICU), Peking University Shenzhen Hospital, Shenzhen, Guangdong, China
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