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M94A0590.TXT
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1994-10-21
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Document 0590
DOCN M94A0590
TI Relapsing Helicobacter cinaedi bacteremia in an AIDS patient.
DT 9412
AU Munckhof WJ; Street AC; Tee W; Fairfield Hospital, Vic.
SO Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:91 (poster no. 33).
Unique Identifier : AIDSLINE ASHM5/94349065
AB Helicobacter cinaedi is a rare cause of gastroenteritis and bacteremia
occurring most commonly in immunocompromised patients. We report a case
of Helicobacter cinaedi bacteremia in an AIDS patient that relapsed
despite a course of adequate antibiotic treatment. A 33 year old patient
with AIDS diagnosed 1 year previously was being treated with zidovudine
when a large cell lymphoma of the larynx was diagnosed. His CD4 cell
count was less than 50/microliters. Chemotherapy was commenced and he
developed febrile neutropenia and mild diarrhoea an was treated with
ceftazidime. Faecal Clostridium difficile toxin assay was positive and
oral vancomycin was added. Blood cultures became positive on day 3 of
incubation (Bactec system), and curved Gram negative rods were seen on
smear. The organism was further identified as Helicobacter cinaedi.
Antibiotic sensitivity testing was difficult, but apparent sensitivity
was demonstrated to erythromycin, gentamicin and ciprofloxacin. Faecal
cultures were negative. Gentamicin was started, and fever settled. He
was treated for 9 days with IV gentamicin, and a further 10 days with
oral ciprofloxacin, after which blood cultures were negative. A month
later, he was readmitted with septic shock and died within a day. Blood
cultures grew Staph aureus and Helicobacter cinaedi.
DE Adult Antibiotics, Combined/THERAPEUTIC USE AIDS-Related Opportunistic
Infections/*DIAGNOSIS/DRUG THERAPY/ MICROBIOLOGY
Bacteremia/*DIAGNOSIS/DRUG THERAPY/MICROBIOLOGY Case Report
Ciprofloxacin/ADMINISTRATION & DOSAGE Fatal Outcome
Gentamicins/ADMINISTRATION & DOSAGE Helicobacter/CLASSIFICATION/DRUG
EFFECTS Helicobacter Infections/*DIAGNOSIS/DRUG THERAPY/MICROBIOLOGY
Human Male MEETING ABSTRACT
SOURCE: National Library of Medicine. NOTICE: This material may be
protected by Copyright Law (Title 17, U.S.Code).