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IDCases 2021A 2-year-old, previously healthy, male presented with an insidious history of intermittent left knee pain and edema who had been evaluated in the emergency department on...
A 2-year-old, previously healthy, male presented with an insidious history of intermittent left knee pain and edema who had been evaluated in the emergency department on multiple occasions with unremarkable imaging and normal laboratory results. On the day of presentation, he had mild edema of the left knee and inability to bear weight. Synovial fluid analysis showed an elevated white cell count with neutrophil predominance and mildly elevated inflammatory markers, consistent with septic arthritis. He underwent knee arthrotomy with irrigation and debridement and was initiated on broad spectrum antibiotics. Cultures were negative, polymerase chain reaction for MRSA and were negative. He was started on a fifth-generation cephalosporin with resolution of symptoms, marked clinical improvement and normalization of inflammatory markers. The identification of the etiologic agent was possible due to detection of bacterial 16S rRNA gene amplification by PCR for in the synovial fluid. He completed a course of 3 weeks of parenteral antibiotics at home with full recovery.
PubMed: 34026535
DOI: 10.1016/j.idcr.2021.e01145 -
European Journal of Ophthalmology Nov 2022Moraxella nonliquefaciens () is a low pathogenicity microorganism, which rarely causes ocular infections, unless there is a predisposing factor. The main clinical...
INTRODUCTION
Moraxella nonliquefaciens () is a low pathogenicity microorganism, which rarely causes ocular infections, unless there is a predisposing factor. The main clinical manifestation of ocular infections is endophthalmitis and only five cases of corneal infection have been reported. This work shows an update in corneal infections, and the first reported case of keratitis due to superinfecting herpes simplex infection.
CASE REPORT
A 84-year old woman with worsening of her herpes simplex keratitis, diagnosed, and treated 2 days before. The slit lamp showed deep paracentral infiltrate and hypopyon. A corneal sample was collected for culture prior to initiation of empiric antibiotic therapy with vancomycin and ceftazidime fortified, oral acyclovir, and cyclopentolate. The strain was identified as and topical antibiotic therapy was adjusted to ciprofloxacin and ceftazidime. After 2 weeks, the epithelial defect and the infiltrate were resolved and prednisolone was added to the regimen. As the corneal oedema and neovascularization decreased, acyclovir, and prednisolone were slowly tapered. About 4 months later, the visual outcome was 20/50 and the ophthalmic examination showed a clear cornea with a paracentral leucoma.
CONCLUSION
Keratitis due to is rare and should be suspected in patients with local predisposing factors such as corneal damage or previous corneal infection. Prompt and appropriate combined treatment for the predisposing lesions and the keratitis may improve the prognosis and avoid a more aggressive approach.
Topics: Acyclovir; Aged, 80 and over; Anti-Bacterial Agents; Ceftazidime; Ciprofloxacin; Cyclopentolate; Female; Humans; Keratitis, Herpetic; Moraxella; Prednisolone; Vancomycin
PubMed: 34015953
DOI: 10.1177/11206721211019565 -
Japanese Journal of Infectious Diseases Sep 2021To improve our current understanding of normal flora in children, we investigated bacterial isolates from the pharynx and nasopharynx of 173 and 233 healthy children,...
To improve our current understanding of normal flora in children, we investigated bacterial isolates from the pharynx and nasopharynx of 173 and 233 healthy children, respectively. The bacterial isolation rates were compared among three age groups: infants (<1 year), toddlers (1-5 years), and school-aged children (6-15 years). Gram-positive cocci were the predominant bacteria in the pharynx (Streptococcus mitis/oralis, 87.3%; Streptococcus salivarius, 54.3%; Rothia mucilaginosa, 41.6%; Staphylococcus aureus, 39.3%). Among infants, S. salivarius and Neisseria subflava, which are related to the development of teeth, were significantly lower than in the other age groups (P <0.0001, S. salivarius; P <0.01, N. subflava). With the exception of Corynebacterium pseudodiphtheriticum (44.2%, gram-positive rods), gram-negative rods largely predominated the nasopharynx (Moraxella catarrhalis, 32.1%; Moraxella nonliquefaciens, 28.3%). Among toddlers, M. catarrhalis and Streptococcus pneumoniae, which are the most common pathogens in acute otitis media, were significantly higher than in the infant group (P <0.05). Among the bacterial species implicated in pediatric respiratory infections, Streptococcus pyogenes was isolated in 3.5% of the pharyngeal samples. S. pneumoniae and Haemophilus influenzae were isolated in 22.3% and 17.2% of the nasopharyngeal samples, respectively. In conclusion, the normal flora of the respiratory tract differs not only by the sampling site but also by the age group.
Topics: Adolescent; Bacterial Infections; Child; Child, Preschool; Female; Gram-Negative Aerobic Rods and Cocci; Gram-Positive Cocci; Haemophilus influenzae; Humans; Infant; Male; Moraxella; Moraxella catarrhalis; Nasopharynx; Pharynx; Pneumococcal Infections; Streptococcus pneumoniae; Streptococcus pyogenes
PubMed: 33642434
DOI: 10.7883/yoken.JJID.2020.824 -
Scientific Reports Nov 2020Nasopharyngeal colonization by bacteria is a prerequisite for progression to respiratory disease and an important source of horizontal spread within communities. We...
Nasopharyngeal colonization by bacteria is a prerequisite for progression to respiratory disease and an important source of horizontal spread within communities. We aimed to perform quantitative analysis of the bacterial cells and reveal the microbiota of the nasal discharge in children at the species level based on highly accurate 16S rRNA gene sequencing. This study enrolled 40 pediatric patients with rhinorrhea. The bacterial cells in the nasal discharge were counted by epifluorescence microscopic analysis. The microbiota was analyzed by using the 16S rRNA gene clone library sequencing method. We demonstrated that a high abundance (median 2.2 × 10 cells/mL) of bacteria was contained in the nasal discharge of children. Of the 40 samples, 37 (92.5%) were dominated by OTUs corresponding to Haemophilus aegyptius/influenzae, Moraxella catarrhalis/nonliquefaciens, or Streptococcus pneumoniae. These samples showed higher cell abundance and lower alpha diversity than the remaining three samples in which the other bacteria coexisted. In addition, 12 sequences with low homology to type strains were considered as previously unknown bacterial lineages. In conclusion, the nasal discharge of most young children contains a large amount of respiratory pathogens and several unknown bacteria, which could not only cause endogenous infection but also be a source of transmission to others.
Topics: Child; Child, Preschool; Female; Haemophilus; Haemophilus influenzae; Humans; Infant; Male; Moraxella; Nasopharynx; RNA, Ribosomal, 16S; Respiratory Tract Infections; Rhinorrhea; Sequence Analysis, RNA; Streptococcus pneumoniae
PubMed: 33214657
DOI: 10.1038/s41598-020-77271-z -
Respiratory Research Jul 2020The elderly (≥65 years) are one of the populations most at risk for respiratory tract infections (RTIs). The aim of this study was to determine whether nasal and/or...
BACKGROUND
The elderly (≥65 years) are one of the populations most at risk for respiratory tract infections (RTIs). The aim of this study was to determine whether nasal and/or oropharyngeal microbiota profiles are associated with age and RTIs.
METHODS
Nasal and oropharyngeal swabs of 152 controls and 152 patients with an RTI were included. The latter group consisted of 72 patients with an upper respiratory tract infection (URTI) and 80 with a lower respiratory tract infection (LRTI). Both nasal and oropharyngeal swabs were subjected to microbiota profiling using amplicon sequencing of the 16S rRNA gene. Moraxella species were determined using quantitative real-time PCR and culture.
RESULTS
Based on the microbiota profiles of the controls and the patients with an RTI, eight nasal and nine oropharyngeal microbiota clusters were defined. Nasal microbiota dominated by either Moraxella catarrhalis or Moraxella nonliquefaciens was significantly more prevalent in elderly compared to mid-aged adults in the control group (p = 0.002). Dominance by M. catarrhalis/nonliquefaciens was significantly less prevalent in elderly with an LRTI (p = 0.001) compared to controls with similar age.
CONCLUSIONS
Nasal microbiota dominated by M. catarrhalis/nonliquefaciens is associated with respiratory health in the elderly population.
Topics: Adolescent; Adult; Age Factors; Aged; Aged, 80 and over; Case-Control Studies; Female; Health Status; Humans; Male; Middle Aged; Moraxella; Moraxella catarrhalis; Nose; Oropharynx; Respiratory Tract Infections; Ribotyping; Risk Assessment; Risk Factors; Young Adult
PubMed: 32664929
DOI: 10.1186/s12931-020-01443-8 -
European Journal of Clinical... Dec 2020We aimed to assess the prevalence, risk factors, and visual outcome of Moraxella keratitis. We retrospectively reviewed the medical charts of patients diagnosed with...
We aimed to assess the prevalence, risk factors, and visual outcome of Moraxella keratitis. We retrospectively reviewed the medical charts of patients diagnosed with Moraxella spp. keratitis at the Quinze-Vingts National Ophthalmology Hospital, Paris, France, between January 2016 and December 2018. Definitive microbiological identification was performed on archival strains using matrix-assisted laser desorption ionization time of flight coupled to mass spectrometry. One hundred one culture-proven cases of Moraxella keratitis were identified. The most common isolates were Moraxella lacunata (50%) and Moraxella nonliquefasciens (38%). Systemic predisposing factors, principally diabetes mellitus (13%) were identified in 28% of patients, and 87% of patients had ocular surface conditions, including blepharitis (25%), prior ocular surgery (21%), glaucoma (17%), exposure keratopathy (16%), and trauma (16%). Severely affected inpatients were treated empirically with fortified antibiotics including vancomycin, piperacillin, and gentamicin. The presence of hypopyon and being over the age of 60 years were associated with a poorer final visual acuity (p < 0.05). Adjuvant treatment, mostly amniotic membrane transplantation, was required for 31 eyes. The prognostic factors significantly associated with the need for adjuvant treatment were a larger infiltrate and hypoesthesia. The clinical features including ulcer healing, treatment duration, and infiltrate size were not different between Moraxella species. Keratitis caused by Moraxella spp. are rare in France but may threaten sight. The early identification of patients with a poor ocular surface, particularly those with neurotrophic keratopathy and anesthetic cornea, is crucial to prevent delayed healing of ulcers and the need for adjuvant treatment.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Anti-Bacterial Agents; Female; Humans; Keratitis; Keratoplasty, Penetrating; Logistic Models; Male; Middle Aged; Moraxella; Moraxellaceae Infections; Paris; Retrospective Studies; Risk Factors; Visual Acuity; Young Adult
PubMed: 32648113
DOI: 10.1007/s10096-020-03985-7 -
Archivos de La Sociedad Espanola de... Nov 2020Bleb-related endophthalmitis is rare and appears months or years after surgery. The causative agents are usually streptococci or gram-negative bacteria. There are few...
Bleb-related endophthalmitis is rare and appears months or years after surgery. The causative agents are usually streptococci or gram-negative bacteria. There are few cases in the literature of endophthalmitis caused by Moraxella nonliquefaciens, and most are delayed-onset associated with blebitis after glaucoma filtration surgery. The case is presented of a 90-year-old patient with endophthalmitis in the right eye due to Moraxella nonliquefaciens associated with blebitis 10 years after glaucoma surgery. After treatment, disappearance of blebitis is observed 2weeks later and resolution of vitritis 29 days later, with recovery of vision to previous values (20/200). Endophthalmitis due to Moraxella nonliquefaciens is rare, and is associated with late onset blebitis after glaucoma filtration surgery. Despite the virulence of the clinical symptoms, the visual prognosis is usually favourable.
PubMed: 32561182
DOI: 10.1016/j.oftal.2020.05.012 -
Archivos de La Sociedad Espanola de... Jul 2020Moraxella keratitis can lead to important complications. Moraxella nonliquefaciens(M. nonliquefaciens) has the worst prognosis. Only three cases of corneal infections...
Moraxella keratitis can lead to important complications. Moraxella nonliquefaciens(M. nonliquefaciens) has the worst prognosis. Only three cases of corneal infections due to M. nonliquefaciens have been published. The case is presented of a 79-year-old man with bullous keratopathy, recently affected with severe infectious keratitis. Dense, deep, and central stromal infiltrates and hyphaema were detected. After the identification of M. nonliquefaciens in the culture, and given the progression of the condition, the initial empirical treatment was modified to topical ciprofloxacin and ceftazidime in accordance with the antibiogram, combining oral ciprofloxacin and amoxicillin-clavulanate. After 27 days, there was total resolution of the lesion, with central residual leucoma. Keratitis caused by M. nonliquefaciens is rare and must be suspected in elderly patients with local predisposing factors, such as corneal damage or previous eye surgery. Early antibiogram-guided treatment and close monitoring are important to avoid complications and poor compliance.
Topics: Aged; Amoxicillin-Potassium Clavulanate Combination; Anti-Bacterial Agents; Ceftazidime; Ciprofloxacin; Corneal Opacity; Corneal Ulcer; Drug Substitution; Eye Infections, Bacterial; Humans; Hyphema; Male; Moraxella; Moraxellaceae Infections; Vancomycin
PubMed: 32241585
DOI: 10.1016/j.oftal.2020.02.012 -
The Journal of Applied Laboratory... Jan 2019
Topics: Female; Humans; Infant; Anti-Infective Agents; Blood Culture; Cryptococcosis; Cryptococcus; Fatal Outcome; Febrile Neutropenia; Histiocytosis, Langerhans-Cell; Microbial Sensitivity Tests; Moraxella; Moraxellaceae Infections; Sepsis; Severity of Illness Index
PubMed: 31639721
DOI: 10.1373/jalm.2018.028142 -
BMC Infectious Diseases Oct 2019Moraxella nonliquefaciens is a usually non-pathogenic biofilm-producing Gram-negative coccobacillus which may colonize the upper respiratory tract, rarely causing...
BACKGROUND
Moraxella nonliquefaciens is a usually non-pathogenic biofilm-producing Gram-negative coccobacillus which may colonize the upper respiratory tract, rarely causing invasive disease. Although very rare, bloodstream infections caused by this organism have been described, showing often a fatal outcome. Here, we report the case of a pediatric cancer patient with bloodstream infection and sepsis due to M. nonliquefaciens showing full recovery after appropriate antibiotic treatment.
CASE PRESENTATION
A three-year-old boy with stage IV neuroblastoma was admitted for high-dose chemotherapy with autologous stem cell rescue after standard neuroblastoma treatment. Despite receiving antimicrobial prophylaxis with trimethoprim/sulfamethoxazole, acyclovir and amphothericin B, the patient presented with fever of up to 39.5 °C and neutropenia. Besides a chemotherapy-related mucositis and an indwelling Broviac catheter (removed), no infection focus was identified on physical examination. Moraxella nonliquafaciens was identified in blood cultures. After antibiotic treatment and neutrophil recovery, the patient was fit for discharge.
CONCLUSIONS
The case described highlights the importance of an otherwise non-pathogenic microorganism, especially in immunosupressed cancer patients. It should be kept in mind that, although very infrequently, Moraxella nonliquefaciens may cause bloodstream infections that can be successfully treated with prompt focus identification and antibiotic therapy.
Topics: Anti-Bacterial Agents; Antineoplastic Agents; Bacteremia; Child, Preschool; Humans; Male; Moraxella; Neoplasm Staging; Neoplasms; Neutropenia; Sepsis
PubMed: 31601195
DOI: 10.1186/s12879-019-4489-y