Recurrent Granulibacter bethesdensis Infections and Chronic Granulomatous Disease

摘要

Chronic granulomatous disease (CGD) is characterized by frequent infections, most of which are curable. Granuli-bacter bethesdensis is an emerging pathogen in patients with CGD that causes fever and necrotizing lymphadenitis. However, unlike typical CGD organisms, this organism can cause relapse after clinical quiescence. To better defi ne whether infections were newly acquired or recrudesced, we use comparative bacterial genomic hybridization to charac-terize 11 isolates obtained from 5 patients with CGD from North and Central America. Genomic typing showed that 3 patients had recurrent infection months to years after appar-ent clinical cure. Two patients were infected with the same strain as previously isolated, and 1 was infected with a ge-netically distinct strain. This organism is multidrug resistant, and therapy required surgery and combination antimicro-bial drugs, including long-term ceftriaxone. G. bethesdensis causes necrotizing lymphadenitis in CGD, which may recur or relapse