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Peripherally inserted central catheter-related bloodstream infection due to Tsukamurella pulmonis: a case report and literature review.

Peripherally inserted central catheter-related bloodstream infection due to Tsukamurella pulmonis: a case report and literature review.
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Suzuki J, Sasahara T, Toshima M, Morisawa Y,


Suzuki J, Sasahara T, Toshima M, Morisawa Y, (click to view)

Suzuki J, Sasahara T, Toshima M, Morisawa Y,

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BMC infectious diseases 2017 10 1117(1) 677 doi 10.1186/s12879-017-2796-8

Abstract
BACKGROUND
Tsukamurella pulmonis is an aerobic gram-positive and rod-shaped organism that causes central catheter-related bloodstream infections in immunocompromised hosts. However, peripherally inserted central catheter (PICC)-related bloodstream infections due to this organism have not been reported.

CASE PRESENTATION
We describe a case of a 48-year-old man with acquired immunodeficiency syndrome and diffuse large B cell lymphoma who received five courses of chemotherapy including rituximab , cyclophosphamide , doxorubicin hydrochloride , vincristine , and prednisone via a PICC. Five days after the last chemotherapy course, he presented with a high fever and shaking chills. His absolute neutrophil count was 4200/μL. Cultures obtained from blood and PICC culture revealed T. pulmonis. The colony count of T. pulmonis grown from PICC culture was 10(3) colony-forming units. Therefore, he was diagnosed with T. pulmonis bacteremia resulting from PICC-related bloodstream infection. The patient’s condition improved and he became afebrile within 48 h after intravenous administration of cefozopran hydrochloride, which is a fourth generation cephalosporin.

CONCLUSIONS
PICCs can be associated with T. pulmonis bacteremia, and fourth generation cephalosporins may be effective treatment.

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