Ruminococcus gnavus bacteraemia in a patient with multiple haematological malignancies
2019
We present a case of
Ruminococcus gnavus
sepsis in a woman suffering from multiple myeloma and myelodysplastic syndrome.
R. gnavus
, a Gram-positive coccus and a gut commensal, has been described in nine cases of infection in the literature, with most infections having occurred in patients with either gastrointestinal symptoms or prosthesis infections. In this case,
R gnavus
was identified by mass spectrometry, and showed susceptibility to penicillin, meropenem, tetracycline, metronidazole and clindamycin. The patient was successfully treated initially with intravenous piperacillin/tazobactam and metronidazole, and then switched to oral penicillin and metronidazole. The cause of infection is hypothesized to have been a shift in the gut microbiota towards an excess growth of
R. gnavus
caused by immunosuppression, and bacterial translocation across a vulnerable mucosal barrier due to prednisolone treatment and severe thrombocytopenia.
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