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KMID : 0377520180430010031
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Chung-Ang Journal of Medicine
2018 Volume.43 No. 1 p.31 ~ p.36
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Weissella confusa Bacteremia in Immunocompromised Host and Literature Review
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Kim Hyun-Ji
Chung Jin-Won
Lee Mi-Kyung
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Abstract
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A 66-year-old man who had undergone steroid treatment with adult onset Still's disease (AOSD) 6 weeks ago was admitted to the emergency room with fever lasting 7 days and received meropenem and vancomycin as empirical antibiotics. Hemophagocytic lymphohistiocytosis was diagnosed in a bone marrow test to confirm the cause of persistent fever. After 3 weeks of treatment, a Gram positive coccobacillus was identified in a blood culture for the detection of febrile neutropenic fever. It was not identified as a Vitek II ANC card (bioMerieux, Inc.), but was identified as Weissella confusa by Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) and 16S rRNA test. W. confusa is resistant to vancomycin and cannot be identified by the currently available phenotype identification method, thus delayed treatment of appropriate antimicrobial agents. Currently, the mechanism of infection is not clearly known. However, it is thought that infection pathway such as change of intestinal flora due to the use of vancomycin and dislocation due to intestinal wall damage after chemotherapy is considered to be possible. We report a case of W. confusa infection diagnosed in an immunocompromised adult and the need for further identification with W. confusa infection by MALDI-TOF MS and 16S rRNA test.
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KEYWORD
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Weissella confusa, Neutropenic fever, Immunocompromised host, MALDI-TOF MS, 16S rRNA
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