ro13-9904 and Helicobacter-Infections

Encephalopathy is a rare side effect of cephalosporin treatment. We herein present a case of encephalopathy induced by ceftriaxone, a third-generation cephalosporin, in a patient with renal failure. An 86-year-old woman on maintenance hemodialysis received ceftriaxone for Helicobacter cinaedi bacteremia. Her mental status deteriorated during antibiotic treatment, and an electroencephalogram revealed triphasic waves predominantly in the frontal area. Her consciousness improved after the discontinuation of the antibiotic due to the suspicion of ceftriaxone-induced encephalopathy. This is the first reported case of encephalopathy associated with high plasma and cerebrospinal fluid ceftriaxone concentrations, and provides significant evidence for a causal relationship between the administration of ceftriaxone and the onset of encephalopathy.

Topics: Aged, 80 and over; Anti-Bacterial Agents; Bacteremia; Brain Diseases; Ceftriaxone; Electroencephalography; Female; Helicobacter Infections; Humans; Renal Dialysis

A 65-year-old Japanese man with bilateral carotid atherosclerosis presented with right neck pain and fever. Contrast-enhanced computed tomography suggested carotid arteritis, and carotid ultrasonography showed an unstable plaque. The patient developed a cerebral embolism, causing a transient ischemic attack. Helicobacter cinaedi was detected in blood culture, and H. cinaedi-associated carotid arteritis was diagnosed. Empirical antibiotic therapy was administered for 6 weeks. After readmission for recurrent fever, he was treated another 8 weeks. Although the relationship between H. cinaedi infection and atherosclerosis development remains unclear, the atherosclerotic changes in our patient's carotid artery might have been attributable to H. cinaedi infection.

Topics: Aged; Anti-Bacterial Agents; Arteritis; Bacteremia; Carotid Artery Diseases; Ceftriaxone; Helicobacter; Helicobacter Infections; Humans; Male; Meropenem; Thienamycins

Topics: Anti-Bacterial Agents; Bacteremia; Ceftriaxone; Doxycycline; Febrile Neutropenia; Helicobacter; Helicobacter Infections; Humans; Male; Microbial Sensitivity Tests; Middle Aged; Multiple Myeloma; RNA, Ribosomal, 16S

There have been various reports concerning Helicobacter cinaedi infections. However, few reports have examined central nervous system infections.. A 52-year-old man was transferred from the local hospital because of a persistent headache and suspected intracranial subdural empyema. Neurosurgical drainage was performed via burr holes. Gram staining and results from abscess cultures were negative. The blood culture yielded H. cinaedi. He was given an antibiotic regimen consisting of 2 g of ceftriaxone twice a day, but the size of the abscess was not reduced in size at all after 3 weeks of treatment. Neurosurgical drainage was performed again, and the antimicrobial regimen was switched to 2 g of meropenem 3 times a day. The size of the abscess was reduced after 2 weeks of the second drainage and antimicrobial drug change to meropenem. After 4 weeks treatment with meropenem, the patient was discharged, and his symptoms had completely resolved.. H. cinaedi infection should be considered in the differential diagnosis of subdural empyema cases for which Gram staining and abscess culture results are negative. Meropenem can be a first-line drug of choice or an effective alternative treatment for H. cinaedi central nervous system infections.

Topics: Abscess; Anti-Bacterial Agents; Anti-Infective Agents; Bacteremia; Ceftriaxone; Drainage; Empyema, Subdural; Helicobacter; Helicobacter Infections; Humans; Male; Meropenem; Middle Aged; Thienamycins; Treatment Outcome

A 43-year-old man was referred to our hospital for an acute-onset fever and left flank pain. He had been previously diagnosed with lymphangioma, and abdominal computed tomography showed pararenal cysts with fat stranding around the left kidney, of which infection was subsequently confirmed on magnetic resonance imaging. Gram-negative spiral bacilli were isolated from two sets of blood cultures, and Helicobacter cinaedi was identified using 16S rRNA sequencing. The patient was successfully treated with ceftriaxone therapy without recurrence. A multilocus sequence typing analysis indicated the current H. cinaedi strain differed from previous strains isolated in Japan.

Topics: Adult; Bacteremia; Ceftriaxone; Helicobacter; Helicobacter Infections; Humans; Japan; Lymphocele; Male; Multilocus Sequence Typing; Radiography; RNA, Ribosomal, 16S

A 56-year-old previously healthy man was hospitalized due to a 10-day history of neck pain and an elevated C-reactive protein level. Gram-negative spiral bacilli were isolated from his blood, and Helicobacter cinaedi was confirmed using 16S rRNA sequencing. The infectious focus was not identified by initial cervical magnetic resonance imaging (MRI); however, repeated MRI demonstrated prominent high signal intensity in the entire region of the C6-C7 vertebrae and C6/C7 disc space. Furthermore, fluorodeoxyglucose-positron emission tomography/computed tomography showed no significant uptake, other than in the C6-C7 region. The patient was successfully treated with ceftriaxone for six weeks without sequelae.

Topics: C-Reactive Protein; Ceftriaxone; Cervical Vertebrae; Diagnosis, Differential; Helicobacter; Helicobacter Infections; Humans; Immunocompromised Host; Magnetic Resonance Imaging; Male; Middle Aged; Osteomyelitis; RNA, Ribosomal, 16S; Tomography, X-Ray Computed

Cardiac tumors and tumor-like lesions are uncommon; most are true neoplasms. We here report a case of a pericoronary tumor-like lesion surrounding the right coronary artery in a 39-year-old man who presented with fever and chest pain. Although clarithromycin was administered for 1 week, his fever persisted. Helicobacter cinaedi (H. cinaedi) was isolated from blood cultures and found to be sensitive to ceftriaxone. A computed tomography scan showed a tumor-like lesion with no (18)F-fl uorodeoxyglucose uptake surrounding the right coronary artery. After administration of ceftriaxone, the tumor-like lesion diminished in size according to meticulous computed tomography examinations. We therefore concluded that it was caused by H. cinaedi infection. The patient has been followed up closely for 1 year and remains asymptomatic.

Topics: Adult; Anti-Bacterial Agents; Ceftriaxone; Coronary Vessels; Diagnosis, Differential; Granuloma, Plasma Cell; Heart Diseases; Helicobacter; Helicobacter Infections; Humans; Injections, Intravenous; Magnetic Resonance Imaging, Cine; Male; Tomography, X-Ray Computed