A case report of the differential diagnosis of Cellulosimicrobium cellulans -infected endocarditis combined with intracr
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CASE REPORT
Open Access
A case report of the differential diagnosis of Cellulosimicrobium cellulans-infected endocarditis combined with intracranial infection by conventional blood culture and second-generation sequencing Huifang Zhang1†, Chunyan He2†, Rui Tian1 and Ruilan Wang1*
Abstract Background: Cellulosimicrobium cellulans is a gram-positive filamentous bacterium found primarily in soil and sewage that rarely causes human infection, especially in previously healthy adults, but when it does, it often indicates a poor prognosis. Case presentation: We report a case of endocarditis and intracranial infection caused by C. cellulans in a 52-yearold woman with normal immune function and no implants in vivo. The patient started with a febrile headache that progressed to impaired consciousness after 20 days, and she finally died after treatment with vancomycin combined with rifampicin. C. cellulans was isolated from her blood cultures for 3 consecutive days after her admission; however, there was only evidence of C. cellulans sequences for two samples in the second-generation sequencing data generated from her peripheral blood, which were ignored by the technicians. No C. cellulans bands were detected in her cerebrospinal fluid by second-generation sequencing. Conclusions: Second-generation sequencing seems to have limitations for certain specific strains of bacteria. Keywords: Cellulosimicrobium cellulans, Second-generation sequencing, Infectious endocarditis, Case report
Background Cellulosimicrobium cellulans, formerly known as Oerskovia xanthineolytica, is a gram-positive filamentous bacterium found primarily in soil and sewage that rarely causes human infection, with only approximately 30 cases reported to date. In the reported cases, infections occurred mainly in immunocompromised hosts, patients with medically relevant implants, and newborns. We * Correspondence: [email protected] † Huifang Zhang and Chunyan He contributed equally to this work. 1 Emergency & Critical Care Department, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, 650 New Songjiang Road, Songjiang District, Shanghai, China Full list of author information is available at the end of the article
report a case of endocarditis and intracranial infection caused by C. cellulans in a 52-year-old woman with normal immune function and no implants in vivo. We found differences between the results of conventional blood culture and second-generation sequencing. Secondgeneration sequencing seems to have limitations for specific strains of bacteria.
Case presentation A 52-year-old rural housewife was admitted to our hospital with a sudden consciousness disorder and weakness of the right limb. One week prior, she was admitted to the local hospital with fever and headache and received
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