Bacteremia in man by gardnerella vaginalis and abscess in legs by pseudomona aeruginosa

• Autores: Patricia Monje Agudo, Mª Asunción Navarro Puerto, Álvaro Martínez Alcalá García, Luis María Jiménez Liñán, Francisco Gallo Puelles, Ana Isabel Aller
• Localización: European journal of clinical pharmacy: atención farmacéutica, ISSN 2385-409X, Vol. 17, Nº. 2, 2015, pág. 9
• Idioma: inglés
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• Resumen

  • Introduction: Gardnerella vaginalis is a Gram-variable coccobacillus. This organism is associated with infections in women but bacteremia is uncommon in them. Studies showed that 7-11% of men have G. vaginalis as part of their urogenital/anorectal flora.The literature showed cases of bacteremia by G. vaginalis in male patients with risk factors such as immunosuppression, genitourinary anatomic abnormalities and alcoholism.

    Treatment of this bacteremia in men is not clearly defined.The most commonly used treatments are B-lactams,tetracyclines, cephalosporins, clindamycin, chloramphenicol, and metronidazole alone or in combination.

    Clinical evolution and result: An 83-year-old man came up to the hospital for fever, edemas in lower limbs and general bad condition. Ten years before, he was intervened of prostate and bladder cancer,without data of recurrence.The first suspicion was urinary and/or respiratory infection. The empiric antibiotics were not improving the patient and the lower limbs continued with plenty of edemas.Abscesses were found in a CT. Pseudomona aeruginosa were isolated from their culture. A gram-negative bacillus, G. vaginalis was isolated from the blood culture.The department of urology denied urologic provenience of the bacteremia by G. vaginalis.

    Discussion: The antibiotic management was complicated. For G. vaginalis, the treatment of choice could be clindamycin or metronidazole. As alternatives, amoxicillin-clavulanic or vancomycin. In our case, we used clindamycin 600mg/6h IV + amoxicillin-clavulanic 1g/8h. For abscesses, imipenem 1g/8h.

    In conclusion, this is a case of bacteremia by G. vaginalis in a man with urological history and other complications which made the antibiotic management difficult