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Leptotrichia trevisanii Sepsis after Bone Marrow Transplantation

Centers for Disease Control and Prevention
Publication Date
DOI: 10.3201/eid1910.121048
  • Letters To The Editor
  • Letter
  • Medicine


LETTERS Leptotrichia trevisanii Sepsis after Bone Marrow Transplantation To the Editor: Leptotrichia spp. have been identified as the cause of various infections. However, the most commonly reported infection is bacte- remia in the setting of chemotherapy for hematologic malignancies (1,2). Only recently has L. trevisanii emerged as a cause of infection; case reports are rare (3–5). We recently observed 3 cases of L. trevisanii bacteremia in patients who had recently undergone peripheral blood stem cell transplan- tation (SCT.) Our goal was to identify possible causes of these infections. The patients were 2 men and 1 woman (ages 53, 56, and 63 years, respectively) who had received my- eloablative chemotherapy. The 2 men had multiple myeloma and relapsed follicular non-Hodgkin lymphoma and had neutropenic fever 5 and 4 days post-SCT, respectively. The woman had acute myelogenous leukemia that had arisen from a myelodysplastic syndrome after matched sibling donor SCT failure. She had neutropenic fe- ver on day 13 of induction therapy. Multiple blood cultures from >1 site (peripheral and central venous catheter [CVC] or 2 separate CVCs) obtained from each patient during the initial febrile episode grew L. trevisa- nii. For the 2 patients with positive cultures for peripheral blood and CVC sites, the peripheral culture was re- ported as positive before the CVC cul- ture but not before use of the CVC. All subsequent blood cultures and cathe- ter tip cultures from these patients had negative results for bacteria. All organisms were cultured by using the BacT/ALERT 3D blood cul- ture instrument (bioMeriéux, Durham, NC, USA) and standard aerobic and anaerobic media. Times to positiv- ity were approximated (range 28–58 hours). Gram staining of isolates from culture media showed large, fusiform gram-negative rods. One isolate had gram-positive beading and was re- ported as gram variable. A second isolate grew anaerobically from initial subculture o

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