Campylobacter coli Bacteremia In An Immunosuppressed Patient

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Campylobacter species, Gram-negative, curved-shaped bacteria, are mainly cause of bacterial gastroenteritis, also reported in cases such as bacteremia, hepatitis, pancreatitis. We present a case of C. coli bacteremia in an immunosuppressed patient with underlying diseases. A 17-year-old boy with thalassemia major, graft-versus-host disease (GvHD), B-cell immunodeficiency, admitted to the emergency department for 39°C fever and rhinitis. On physical examination, patient was tachycardic, breathing sounds were lost in bases of the lungs. Thorax CT interpreted as viral-atypical pneumonia; COVID-19 PCR test resulted positive. He was hospitalized; blood, urine, throat cultures were taken and piperacillin-tazobactam, teicoplanin, favipiravir were started. The prophylaxis dose of amoxicillin, acyclovir, fluconazole, trimethoprim-sulfamethoxazole treatment was continued. Third day of incubation blood culture system (Bactec FX;Becton Dickinson-USA) gave positive signal, direct Gram preparation showed Gram-negative, curved/spiral rods (Figure) and likened to Campylobacter . Azithromycin was added to treatment. The isolate grew under microaerophilic atmosphere was identified as C. coli with the MALDI-TOF MS (bioMérieux-France) and was resistant to ciprofloxacin, sensitive to erythromycin and tetracycline. Due to Campylobacter bacteremia patient was consulted for gastro-intestinal GvHD but was not associated as it because it wasn't accompanied by diarrhea-vomiting, weight loss and a long time had passed after the transplantation. It has been associated with existing B-cell deficiency. Campylobacter bacteremia should be kept in mind particularly in immunocompromised patients and if spiral/gull-wing-shaped Gram-negative rods are seen on direct Gram staining or if there is no growth in subcultures, incubation in microaerophilic environment will help the diagnosis.

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