Journal of Global Infectious Diseases

LETTERS TO EDITOR
Year
: 2018  |  Volume : 10  |  Issue : 2  |  Page : 113--114

Oerskovia species bacteremia in a diabetic patient


Katerina G Oikonomou, Carla Sue Mcwilliams, Marwa M Moussa 
 NYU Lutheran Medical Center, New York University School of Medicine, New York, USA

Correspondence Address:
Dr. Katerina G Oikonomou
Department of Medicine, NYU Lutheran Medical Center, 150 55th Street, Brooklyn, NY 11220
USA




How to cite this article:
Oikonomou KG, Mcwilliams CS, Moussa MM. Oerskovia species bacteremia in a diabetic patient.J Global Infect Dis 2018;10:113-114


How to cite this URL:
Oikonomou KG, Mcwilliams CS, Moussa MM. Oerskovia species bacteremia in a diabetic patient. J Global Infect Dis [serial online] 2018 [cited 2020 Dec 4 ];10:113-114
Available from: https://www.jgid.org/text.asp?2018/10/2/113/232998


Full Text



Sir,

Oerskovia species are present mainly in soil and water and are rarely pathogenic for human disease.[1],[2],[3]Oerskovia species represent Gram-positive rod-shaped microorganisms, which were first isolated and described as motile Nocardia.[1] The organism may be distinguished from Nocardia species by the yellow-pigmented colonies without aerial hyphae, motility, and lack of partial acid-fastness.[1],[4],[5] We describe the case of a patient with uncontrolled diabetes mellitus with bacteremia due to Oerskovia species.

A homeless man in his early fifties presented with bilateral lower extremity pain and weakness. Physical examination was significant for multiple plantar and dorsal foot ulcerations with multiple exposed bones and tendons bilaterally. The patient was septic and was started on broad spectrum antibiotic coverage, intravenous vancomycin 1 g every 12 h, cefepime 2 g every 12 h, and metronidazole 500 mg every 8 h for severe skin and soft tissue infection and suspected chronic osteomyelitis. Blood cultures grew Oerskovia species. The most probable source of entry was the open, chronic diabetic foot wounds. In addition, we suspect that patient's severely uncontrolled diabetes mellitus resulted in impaired cellular immunity and susceptibility to invasive infection with this unusual pathogen. Due to patient's nonadherence to intravenous antibiotic administration, the regimen was switched to oral sulfamethoxazole–trimethoprim. Given the severity of infection, the patient underwent a left foot second digit and second metatarsal head resection and right foot transmetatarsal amputation. The patient completed a 21-day course of antibiotic treatment with clearance of bacteremia.

Only a few cases of human infections caused by Oerskovia species have been published to date. Experience with Oerskovia species infections and outcome of treatment is limited. Further studies are required to clarify mechanisms of pathogenicity and clinical manifestations of infections due to Oerskovia species.[4],[5]

Declaration of patient consent

The authors certify that they have obtained all appropriate patient consent forms. In the form the patient(s) has/have given his/her/their consent for his/her/their images and other clinical information to be reported in the journal. The patients understand that their names and initials will not be published and due efforts will be made to conceal their identity, but anonymity cannot be guaranteed.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

References

1Ellerbroek P, Kuipers S, Rozenberg-Arska M, Verdonck LF, Petersen EJ. Oerskovia xanthineolytica: A new pathogen in bone marrow transplantation. Bone Marrow Transplant 1998;22:503-5.
2Sug Kim J, Won Lee T, Gyoo Ihm C, Jin Kim Y, Mi Moon S, Joo Lee H, et al. CAPD peritonitis caused by co-infection with Cellulosimicrobium cellulans (Oerskovia xanthineolytica) and Enterobacter cloacae: A case report and literature review. Intern Med 2015;54:627-30.
3Borra S, Kleinfeld M. Peritonitis caused by Oerskovia xanthineolytica in a patient on chronic ambulatory peritoneal dialysis (CAPD) Am J Kidney Dis 1996;27:458.
4McDonald CL, Chapin-Robertson K, Dill SR, Martino RL. Oerskovia xanthineolytica bacteremia in an immunocompromised patient with pneumonia. Diagn Microbiol Infect Dis 1994;18:259-61.
5Lair MI, Bentolila S, Grenet D, Cahen P, Honderlick P. Oerskovia turbata and Comamonas acidovorans bacteremia in a patient with AIDS. Eur J Clin Microbiol Infect Dis 1996;15:424-6.