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Case Reports
, 3 (5), e005069

Successful Treatment of Recurrent Helicobacter fennelliae Bacteraemia by Selective Digestive Decontamination With Kanamycin in a Lung Cancer Patient Receiving Chemotherapy

Case Reports

Successful Treatment of Recurrent Helicobacter fennelliae Bacteraemia by Selective Digestive Decontamination With Kanamycin in a Lung Cancer Patient Receiving Chemotherapy

Yoshihiro Fujiya et al. JMM Case Rep.


Introduction: Helicobacter fennelliae is an enterohepatic Helicobacter species causing bacteraemia in immunocompromised hosts. Only a few cases of recurrent H. fennelliae bacteraemia have been reported in Japan and there are no guidelines regarding antimicrobial treatment for H. fennelliae infection.

Case presentation: H. fennelliae bacteraemia was observed in a patient receiving platinum-based chemotherapy for lung cancer. To prevent recurrence, the patient received antibiotic therapy with cefepime, amoxicillin and doxycycline for 6 weeks, which is similar to the therapy for Helicobactercinaedi bacteraemia. Bacteraemia recurred despite the long-term antibiotic therapy. We hypothesized that the H. fennelliae bacteraemia originated from endogenous infection in the intestinal tract due to the long-term damage of the enteric mucosa by platinum-based drugs and performed selective digestive decontamination (SDD) with kanamycin. Bacteraemia did not recur after SDD.

Conclusion: Our observations indicate that clinicians should be aware of possible recurrent H. fennelliae bacteraemia, which could be effectively prevented by SDD with kanamycin.

Keywords: Helicobacter fennelliae; recurrent bacteremia, lung cancer, chemotherapy; selective digestive decontamination, kanamycin.


Fig. 1.
Fig. 1.
Phylogenetic tree based on the GyrA protein sequences showing the position of our two isolates (HF-1 and HF-2) within the genus Helicobacter. GenBank/EMBL/DDBJ accession numbers and type strains are indicated. The numbers at the branching points are bootstrap percentages (based on 1000 replications). The evolutionally distances were computed using the Kimura empirical model, and the phylogenetic tree was constructed using the NJplot software. The bar represents 1 inferred amino acid substitution per 100 amino acids.

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