Document 0590
 DOCN  M94A0590
 TI    Relapsing Helicobacter cinaedi bacteremia in an AIDS patient.
 DT    9412
 AU    Munckhof WJ; Street AC; Tee W; Fairfield Hospital, Vic.
 SO    Annu Conf Australas Soc HIV Med. 1993 Oct 28-30;5:91 (poster no. 33).
       Unique Identifier : AIDSLINE ASHM5/94349065
 AB    Helicobacter cinaedi is a rare cause of gastroenteritis and bacteremia
       occurring most commonly in immunocompromised patients. We report a case
       of Helicobacter cinaedi bacteremia in an AIDS patient that relapsed
       despite a course of adequate antibiotic treatment. A 33 year old patient
       with AIDS diagnosed 1 year previously was being treated with zidovudine
       when a large cell lymphoma of the larynx was diagnosed. His CD4 cell
       count was less than 50/microliters. Chemotherapy was commenced and he
       developed febrile neutropenia and mild diarrhoea an was treated with
       ceftazidime. Faecal Clostridium difficile toxin assay was positive and
       oral vancomycin was added. Blood cultures became positive on day 3 of
       incubation (Bactec system), and curved Gram negative rods were seen on
       smear. The organism was further identified as Helicobacter cinaedi.
       Antibiotic sensitivity testing was difficult, but apparent sensitivity
       was demonstrated to erythromycin, gentamicin and ciprofloxacin. Faecal
       cultures were negative. Gentamicin was started, and fever settled. He
       was treated for 9 days with IV gentamicin, and a further 10 days with
       oral ciprofloxacin, after which blood cultures were negative. A month
       later, he was readmitted with septic shock and died within a day. Blood
       cultures grew Staph aureus and Helicobacter cinaedi.
 DE    Adult  Antibiotics, Combined/THERAPEUTIC USE  AIDS-Related Opportunistic
       Infections/*DIAGNOSIS/DRUG THERAPY/  MICROBIOLOGY
       Bacteremia/*DIAGNOSIS/DRUG THERAPY/MICROBIOLOGY  Case Report
       Ciprofloxacin/ADMINISTRATION & DOSAGE  Fatal Outcome
       Gentamicins/ADMINISTRATION & DOSAGE  Helicobacter/CLASSIFICATION/DRUG
       EFFECTS  Helicobacter Infections/*DIAGNOSIS/DRUG THERAPY/MICROBIOLOGY
       Human  Male  MEETING ABSTRACT

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