Abstract
We herein report a case of acute cholangitis and bacteremia caused by a commensal Neisseria species, Neisseria subflava, in an 82-year-old man with cholangiocarcinoma. Emergency endoscopic nasobiliary drainage and cefoperazone/sulbactam therapy were effective. Gram negative coccobacilli were isolated from both blood and bile cultures on 5% sheep blood agar. The isolate was identified as N.subflava biovar perflava by mass spectrometry, a sequence analysis of the 16S rRNA, and biochemical testing. Although biliary infections due to commensal Neisseria are extremely rare, this case demonstrates the possibility of its occurrence in patients undergoing bile duct treatment.
MeSH terms
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Acute Disease
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Aged, 80 and over
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Anti-Bacterial Agents / administration & dosage
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Anti-Bacterial Agents / therapeutic use
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Bacteremia / complications
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Bacteremia / diagnosis*
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Bacteremia / diagnostic imaging
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Bacteremia / therapy
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Cefoperazone / administration & dosage
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Cefoperazone / therapeutic use
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Cholangiocarcinoma*
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Cholangitis / complications
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Cholangitis / diagnosis*
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Cholangitis / diagnostic imaging
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Cholangitis / therapy
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Diagnosis, Differential
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Drainage
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Drug Therapy, Combination
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Humans
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Male
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Neisseria / isolation & purification*
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Pancreaticoduodenectomy
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Sulbactam / administration & dosage
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Sulbactam / therapeutic use
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Tomography, X-Ray Computed
Substances
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Anti-Bacterial Agents
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Cefoperazone
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Sulbactam