Case Report
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A Rare Bacterial Pneumonia in a Patient Followed by Diagnosis of Chronic Obstructive Pulmonary Disease; Gemella haemolysans

Year 2018, Volume: 2 Issue: 2, 117 - 121, 29.09.2018

Abstract

In
this report, pneumonia table which is
caused by Gemella haemolysans,
a rare occurrence, purely produced from a tracheal aspirate culture of a
patient followed by COPD diagnosis is presented.

Our case; A 67-year-old male patient, who
has been diagnosed COPD for 5 years, admitted to the chest diseases clinic with
complaints of increased cough and rising fever. It was determined that the
breathing sounds were roughening, extension in the expiration, and rallies in
the upper part of the right lung in his examination. In laboratory tests;
erythrocyte sedimentation rate: 98 mm / h, and complete blood count: leucocyte:
9980 / ml, whereas opacity was found at right lung upper zone in his chest
radiography. In gram staining of tracheal aspirate sample; polymorphic core
leukocytes and gram positive cocci were seen intensely (higher than 25 in each
area). In the culture of the tracheal aspirate sample, large, matt and S-type
pure colonies producing alpha-hemolysis in been sheep blood agar medium grew.
By the mass spectrometry method, this bacterium has identified as Gemella haemolysans. According to the
results of the antibiotic susceptibility test, this bacteria was found to be
sensitive to benzilpenicillin, ampicillin, cefotaxime, tetracycline,
gemifloxacin, clindamycin and ceftriaxone while resistant to levofloxacin and
erythromycin. The patient was treated with 1x1 320 mg gemifloxacin for 7 days
and the patient's clinic was improved after this treatment.





 As a
result; It should be kept in mind that   Gemella haemolysans
may be an opportunistic pathogen in patients with an underlying disease and
immunodeficiency, especially in patients with intensive care as well as other
rare infectious agents.  And what is
more, since this bacterium is known to be resistant to some antibiotics,
treatment should definitely be directed based on the antibiotic susceptibility
tests. 

References

  • KAYNAKLAR1. Thjotta T, Boe J. Neisseria haemolysans. A hemolytic species of Neisseria trevisan. Acta Pathol Mirobiol Scand 1938; Suppl. 37: 527-31.2. Reyn A, Birch-Andersen A, Berger U. Fine structure and taxonomic position of Neisseria haemolysans (Thjotta and Boe 1938) or Gemella haemolysans (Berger 1960). Acta Pathol Microbiol Scand Microbiol Immunol 1970; 78: 37589.3. Winn W, Allen S, Janda W, et al. Koneman’s Color Atlas and Textbook of Diagnostic Microbiology. 6th ed. Baltimore, MD Lippincott Williams & Wilkins, 2006: 674-7644. Woo PC, Lau SK, Fung AM, Chiu SK, Yung RW, Yuen KY. Gemella bacteraemia characterised by 16S ribozomal RNA gene sequencing. J Clin Pathol 2003; 56(9): 690–693. 5. Turan H, Özdemir Ö, Kurt-Azap Ö, Arslan H. Gemella haemolysans’ ın Etken Olduğu Bir Spondilodiskit ve Paraspinal Apse Olgusu. Klimik Dergisi 2010; 23(3), 138-40.6. Martha B, Duong M, Buisson M et al. Acute Gemella haemolysans spondylodiscitis in an immunocompetent patient. Presse Med 2003; 32(27): 1273-5.7. Lee MR, Lee SO, Kim SY, Yang SM, Seo YH, Cho YK. Brain abscess due to Gemella haemolysans. J Clin Microbiol 2004; 42(5): 2338-40.8. Raman SV, Evans N, Freegard TJ, Cunnigham R. Gemella haemolysans acute postoperative endophtalmitis. Br J Ophthalmol 2003; 87(9): 1192-3.9. Serarslan G, Çetin M. Cutaneous leishmaniasis secondarily infected by Gemella haemolysans. Ankem Derg 2008; 22(1): 37-8.10. Khan R, Urban C, Rubin D, Segal-Maurer S. Subacute endocarditis caused by Gemella haemolysans and a review of the literature. Scand J Infect Dis. 2004; 36(11-12): 885-8.11. Kaya E, Sayan M, Tokur M, Aral M. "Gemella haemolysans’ın Etken Olduğu Bir Ampiyem Olgusu." Türk Mikrobiyol Cem Derg 2017; 47(2): 94-96. 12. Eisenhut M, Jones C, Hughes D, Herrington S, Kokai G. Acute renal failure associated with Gemella haemolysans pneumonia. Pediatric Nephrology 2004; 19(4): 448-450.13. Köksal İ, Özlü T, Saral OB, et al. The etiological agents in adult patients with community acquired lower respiratory tract infections in Turkey. 17th ECCMID, 31 March-3April 2007, Munich/Germany.14. Clinical and Laboratory Standards Institute. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. Approved Standard. M7-A7. Wayne, PA: CLSI, 2017.15. Salceanu SO, Levy S, Cunningham R, Frimpong-Ansah K. Severe Gemella haemolysans endophthalmitis following ranibizumab intravitreal injection. Indian Journal of Ophthalmology 2017; 65(11): 1249-1251.16. Reed C, Efstratiou A, Morrison D, Woodford N. Glycopeptide-resistant Gemella haemolysans from blood. Lancet 1993; 342: 927-928.

KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI TANISI ile TAKİP EDİLEN HASTADA NADİR BİR BAKTERİYEL PNÖMONİ ETKENİ; GEMELLA HAEMOLYSANS

Year 2018, Volume: 2 Issue: 2, 117 - 121, 29.09.2018

Abstract

Bu
raporda; KOAH tanısı ile takip edilen bir hastanın trakeal aspirat kültüründen
saf olarak üretilen nadir karşılaşılan bir etken olan Gemella haemolysans’ın neden olduğu pnömoni tablosu sunulmuştur.

Olgumuz;
5 yıldan beri KOAH tanısıyla takip edilen 67 yaşında erkek hasta olup, artan
öksürük ve yükselen ateş şikayeti ile göğüs hastalıkları polikliniğine
başvurmuştur. Muayenesinde dinlemekle solunum seslerinde kabalaşma, ekspiryumda
uzama, sağ akciğer üst bölümde ralleri olduğu saptanmıştır. Laboratuvar
testlerinde; eritrosit sedimentasyon hızı: 98 mm/h ve tam kan sayımı: Lökosit:
9980/ml iken, akciğer grafisinde sağ akciğer üst zonda opasite olduğu
görülmüştür. Trakeal aspirat örneğinin gram boyamasında; yoğun (her alanda 25
den fazla) polimorf nüveli lökositler ve gram pozitif koklar görülmüştür. Trakeal
aspirat örneğinin kültüründe koyun kanlı agar besiyerinde alfa-hemoliz
oluşturan, büyük ve mat S tipi saf koloniler üremiştir. Kütle spektrometresi
yöntemi ile bu bakteri Gemella
haemolysans
olarak tanımlanmıştır. Antibiyotik duyarlılık testi sonucuna
göre bu bakteri; levofloksasin ve erithromisine karşı dirençli iken benzilpenisilin,
ampisilin, sefotaksim, tetrasiklin, gemifloksasin, klindamisin ve seftriaksona karşı
duyarlı bulunmuştur. Hastaya 7 gün süreyle 1X1 320mg gemifloksasin tedavisi
uygulanmış ve bu tedavi sonrasında hastanın kliniğinde düzelme sağlanmıştır.





Sonuç olarak;  G.
haemolysans
, diğer nadir karşılaşılan enfeksiyon etkenlerinde olduğu gibi
yoğun bakımda hastalar başta olmak üzere altta yatan bir hastalık ve
immünyetmezlik olan hastalarda fırsatçı patojen olabileceği akılda
tutulmalıdır. Ayrıca bu bakterinin bazı antibiyotiklere dirençli olduğu bilindiğinden
mutlaka antibiyotik duyarlılık testlerine göre tedavi yönlendirilmelidir.  
   

References

  • KAYNAKLAR1. Thjotta T, Boe J. Neisseria haemolysans. A hemolytic species of Neisseria trevisan. Acta Pathol Mirobiol Scand 1938; Suppl. 37: 527-31.2. Reyn A, Birch-Andersen A, Berger U. Fine structure and taxonomic position of Neisseria haemolysans (Thjotta and Boe 1938) or Gemella haemolysans (Berger 1960). Acta Pathol Microbiol Scand Microbiol Immunol 1970; 78: 37589.3. Winn W, Allen S, Janda W, et al. Koneman’s Color Atlas and Textbook of Diagnostic Microbiology. 6th ed. Baltimore, MD Lippincott Williams & Wilkins, 2006: 674-7644. Woo PC, Lau SK, Fung AM, Chiu SK, Yung RW, Yuen KY. Gemella bacteraemia characterised by 16S ribozomal RNA gene sequencing. J Clin Pathol 2003; 56(9): 690–693. 5. Turan H, Özdemir Ö, Kurt-Azap Ö, Arslan H. Gemella haemolysans’ ın Etken Olduğu Bir Spondilodiskit ve Paraspinal Apse Olgusu. Klimik Dergisi 2010; 23(3), 138-40.6. Martha B, Duong M, Buisson M et al. Acute Gemella haemolysans spondylodiscitis in an immunocompetent patient. Presse Med 2003; 32(27): 1273-5.7. Lee MR, Lee SO, Kim SY, Yang SM, Seo YH, Cho YK. Brain abscess due to Gemella haemolysans. J Clin Microbiol 2004; 42(5): 2338-40.8. Raman SV, Evans N, Freegard TJ, Cunnigham R. Gemella haemolysans acute postoperative endophtalmitis. Br J Ophthalmol 2003; 87(9): 1192-3.9. Serarslan G, Çetin M. Cutaneous leishmaniasis secondarily infected by Gemella haemolysans. Ankem Derg 2008; 22(1): 37-8.10. Khan R, Urban C, Rubin D, Segal-Maurer S. Subacute endocarditis caused by Gemella haemolysans and a review of the literature. Scand J Infect Dis. 2004; 36(11-12): 885-8.11. Kaya E, Sayan M, Tokur M, Aral M. "Gemella haemolysans’ın Etken Olduğu Bir Ampiyem Olgusu." Türk Mikrobiyol Cem Derg 2017; 47(2): 94-96. 12. Eisenhut M, Jones C, Hughes D, Herrington S, Kokai G. Acute renal failure associated with Gemella haemolysans pneumonia. Pediatric Nephrology 2004; 19(4): 448-450.13. Köksal İ, Özlü T, Saral OB, et al. The etiological agents in adult patients with community acquired lower respiratory tract infections in Turkey. 17th ECCMID, 31 March-3April 2007, Munich/Germany.14. Clinical and Laboratory Standards Institute. Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically. Approved Standard. M7-A7. Wayne, PA: CLSI, 2017.15. Salceanu SO, Levy S, Cunningham R, Frimpong-Ansah K. Severe Gemella haemolysans endophthalmitis following ranibizumab intravitreal injection. Indian Journal of Ophthalmology 2017; 65(11): 1249-1251.16. Reed C, Efstratiou A, Morrison D, Woodford N. Glycopeptide-resistant Gemella haemolysans from blood. Lancet 1993; 342: 927-928.
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Details

Primary Language Turkish
Subjects Health Care Administration
Journal Section Case Report
Authors

Elif Özözen Şahin

Mehmet Köroğlu

Tayfur Demiray

Canatan Taşdemir This is me

Mustafa Altındiş This is me

Publication Date September 29, 2018
Acceptance Date August 27, 2018
Published in Issue Year 2018 Volume: 2 Issue: 2

Cite

AMA Özözen Şahin E, Köroğlu M, Demiray T, Taşdemir C, Altındiş M. KRONİK OBSTRÜKTİF AKCİĞER HASTALIĞI TANISI ile TAKİP EDİLEN HASTADA NADİR BİR BAKTERİYEL PNÖMONİ ETKENİ; GEMELLA HAEMOLYSANS. J Biotechnol and Strategic Health Res. September 2018;2(2):117-121.
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