Helicobacter cinaedi bacteremia with cellulitis after ABO-incompatible living-donor liver transplantation: Case report

World J Gastroenterol. 2015 Jul 7;21(25):7911-5. doi: 10.3748/wjg.v21.i25.7911.

Abstract

Helicobacter cinaedi (H. cinaedi), a Gram-negative spiral-shaped bacterium, is an enterohepatic non-Helicobacter pylori Helicobacter species. We report the first case of H. cinaedi bacteremia with cellulitis after liver transplantation. A 48-year-old male, who had been a dog breeder for 15 years, underwent ABO-incompatible living-donor liver transplantation for hepatitis C virus-induced decompensated cirrhosis using an anti-hepatitis B core antibody-positive graft. The patient was preoperatively administered rituximab and underwent plasma exchange twice to overcome blood type incompatibility. After discharge, he had been doing well with immunosuppression therapy comprising cyclosporine, mycophenolate mofetil, and steroid according to the ABO-incompatible protocol of our institution. However, 7 mo after transplantation, he was admitted to our hospital with a diagnosis of recurrent cellulitis on the left lower extremity, and H. cinaedi was detected by both blood culture and polymerase chain reaction analysis. Antibiotics improved his symptoms, and he was discharged at day 30 after admission. Clinicians should be more aware of H. cinaedi in immunocompromised patients, such as ABO-incompatible transplant recipients.

Keywords: ABO-incompatible; Bacteremia; Cellulitis; HBc-Ab-positive donor; Helicobacter cinaedi; Hepatitis C; Liver transplantation; Living-donor.

Publication types

  • Case Reports

MeSH terms

  • ABO Blood-Group System / immunology*
  • Animals
  • Anti-Bacterial Agents / therapeutic use
  • Blood Group Incompatibility / immunology*
  • Cellulitis / diagnosis
  • Cellulitis / drug therapy
  • Cellulitis / immunology
  • Cellulitis / microbiology*
  • Dogs / microbiology
  • Feces / microbiology
  • Helicobacter Infections / diagnosis
  • Helicobacter Infections / drug therapy
  • Helicobacter Infections / immunology
  • Helicobacter Infections / microbiology*
  • Helicobacter Infections / transmission
  • Histocompatibility*
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Liver Transplantation / adverse effects*
  • Liver Transplantation / methods
  • Living Donors*
  • Male
  • Middle Aged
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / immunology
  • Opportunistic Infections / microbiology*
  • Opportunistic Infections / transmission
  • Risk Factors
  • Treatment Outcome
  • Zoonoses

Substances

  • ABO Blood-Group System
  • Anti-Bacterial Agents
  • Immunosuppressive Agents