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Helicobacter cinaedi bacteremia with cellulitis after ABO-incompatible living-donor liver transplantation: Case report
Authors:Kohei Mishima  Hideaki Obara  Kayoko Sugita  Masahiro Shinoda  Minoru Kitago  Yuta Abe  Taizo Hibi  Hiroshi Yagi  Kentaro Matsubara  Takehiko Mori  Yaoko Takano  Hiroshi Fujiwara  Osamu Itano  Naoki Hasegawa  Satoshi Iwata  Yuko Kitagawa
Abstract:
Helicobacter cinaedi (H. cinaedi), a Gram-negative spiral-shaped bacterium, is an enterohepatic non-Helicobacter pylori Helicobacter species. We report the first case of H. cinaedi bacteremia with cellulitis after liver transplantation. A 48-year-old male, who had been a dog breeder for 15 years, underwent ABO-incompatible living-donor liver transplantation for hepatitis C virus-induced decompensated cirrhosis using an anti-hepatitis B core antibody-positive graft. The patient was preoperatively administered rituximab and underwent plasma exchange twice to overcome blood type incompatibility. After discharge, he had been doing well with immunosuppression therapy comprising cyclosporine, mycophenolate mofetil, and steroid according to the ABO-incompatible protocol of our institution. However, 7 mo after transplantation, he was admitted to our hospital with a diagnosis of recurrent cellulitis on the left lower extremity, and H. cinaedi was detected by both blood culture and polymerase chain reaction analysis. Antibiotics improved his symptoms, and he was discharged at day 30 after admission. Clinicians should be more aware of H. cinaedi in immunocompromised patients, such as ABO-incompatible transplant recipients.
Keywords:Helicobacter cinaedi   Bacteremia   Cellulitis   Liver transplantation   Hepatitis C   Living-donor   ABO-incompatible   HBc-Ab-positive donor
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