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Journal of Clinical Microbiology, August 1999, p. 2439-2445, Vol. 37, No. 8
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Recurrent Bacteremia Caused by a "Flexispira"-Like Organism in a Patient with X-Linked (Bruton's) Agammaglobulinemia

Susan Weir,1 Brenda Cuccherini,2 Anne M. Whitney,3 Marsha L. Ray,4 John P. MacGregor,3 Arnold Steigerwalt,3 Maryam I. Daneshvar,3 Robbin Weyant,3 Betty Wray,5 John Steele,6 Warren Strober,2 and Vee J. Gill1,*

Microbiology Service, Clinical Pathology Department, W.G. Magnuson Clinical Center,1 and National Institutes of Allergy and Infectious Diseases,2 National Institutes of Health, Bethesda, Maryland, and Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention,3 and Bacteriology Laboratory, Georgia Department of Human Resources,4 Atlanta, and Section of Allergy-Immunology, Departments of Pediatrics and Internal Medicine,5 and Clinical Microbiology Laboratory, Department of Pathology,6 Medical College of Georgia, Augusta, Georgia

Received 17 February 1999/Returned for modification 9 April 1999/Accepted 29 April 1999

Helicobacter spp., except for Helicobacter cinaedi, have only rarely been reported in cases of septicemia. A patient with X-linked (Bruton's) agammaglobulinemia was found to have persistent sepsis with a Helicobacter-like organism despite multiple courses of antibiotics. His periods of sepsis were associated with leg swelling thought to be consistent with cellulitis. The organism was fastidious and required a microaerophilic environment containing H2 for growth. Optimal growth was observed at 35 to 37°C on sheep blood, CDC anaerobe, and Bordet-Gengou agars. Serial subcultures every 4 to 5 days were required to maintain viability. The organism was strongly urease positive and showed highest relatedness to Helicobacter-like organisms with the vernacular name "Flexispira rappini" by 16S rRNA gene sequence analysis. Genomic DNA hybridization studies, however, found 24 to 37% relatedness to "F. rappini" and even less to other Helicobacter spp. Although the organism phenotypically resembles "Flexispira" and Helicobacter, it is thought to represent a new taxon. The patient's infection was eventually cleared with a prolonged (5-month) course of intravenous imipenem and gentamicin.

* Corresponding author. Mailing address: Microbiology Service, Bldg. 10/Rm2C-385, Department of Clinical Pathology, W.G. Magnuson Clinican Center, National Institutes of Health, Bethesda, MD 20892. Phone: (301) 496-4433, Fax: (301) 402-1886. E-mail: vjgill{at}nih.gov.

Journal of Clinical Microbiology, August 1999, p. 2439-2445, Vol. 37, No. 8
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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