Streptomyces thermovulgaris Bacteremia in Crohn’s Disease Patient

摘要

To the Editor: Invasive infectionswith Streptomyces spp. are rare; inreference to two cases reported inEmerging Infectious Diseases (1,2),we describe here the first documentedcase of bacteremia with Streptomycesthermovulgaris. An 81-year-oldwoman was admitted to the emer-gency room of Diakonessenhuis,Utrecht, the Netherlands, with severeabdominal pain in the right lowerquadrant and feculent vomitus. Thepatient had a history of Crohn's dis-ease, for which she had undergoneresection of the ileum and cecum, andwas receiving high-dose corticos-teroid therapy (prednisone 25 mgdaily). The patient also had steroid-induced osteoporosis and an internalpacemaker. On admission, the patienthad a temperature of 35.6°C, a leuko-cyte count of 8.4 x 109/L with 30%bandforms, and a C-reactive proteinlevel of 18 mg/L. Moreover, thepatient had severe metabolic acidosisand was hemodynamically unstable,suggesting septic shock subsequent toa presumed bowel perforation