Bacteremia Possibly Caused by Helicobacter cinaedi and Associated with Painful Erythema in Rheumatoid Arthritis with Malignant Lymphoma

Intern Med. 2018 Dec 15;57(24):3663-3666. doi: 10.2169/internalmedicine.1196-18. Epub 2018 Aug 24.

Abstract

We herein report the case of a 69-year-old woman with rheumatoid arthritis (RA) and malignant lymphoma who developed Helicobacter cinaedi bacteremia after starting rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) chemotherapy. She had a recurrent fever and painful erythema for 13 months before the diagnosis was made. This delayed diagnosis was attributable to the underlying RA, which typically presents with various cutaneous manifestations and elevated C-reactive protein levels. The erythema on the thighs, abdomen, and left forearm improved following treatment with intravenous aminobenzyl penicillin; she received antibiotics for six weeks. This case emphasizes the importance of recognizing this opportunistic infection in immunocompromised patients.

Keywords: Helicobacter cinaedi; malignant lymphoma; painful erythema; rheumatoid arthritis.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Ampicillin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Antineoplastic Combined Chemotherapy Protocols / therapeutic use
  • Arthritis, Rheumatoid / complications*
  • Arthritis, Rheumatoid / drug therapy
  • Bacteremia / complications
  • Bacteremia / diagnosis
  • Bacteremia / drug therapy
  • Bacteremia / microbiology*
  • Erythema / drug therapy
  • Erythema / microbiology*
  • Female
  • Helicobacter Infections / complications*
  • Helicobacter Infections / diagnosis
  • Helicobacter Infections / drug therapy
  • Helicobacter*
  • Humans
  • Immunocompromised Host
  • Lymphoma / complications*
  • Lymphoma / drug therapy
  • Opportunistic Infections / complications
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / drug therapy
  • Opportunistic Infections / microbiology*
  • Pain / microbiology*
  • Recurrence

Substances

  • Anti-Bacterial Agents
  • Ampicillin