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Fatal Chromobacterium violaceum septicaemia in northern Laos, a modified oxidase test and post-mortem forensic family G6PD analysis
Günther Slesak, Phouvieng Douangdala, Saythong Inthalad, Joy Silisouk, Manivanh Vongsouvath, Amphonesavanh Sengduangphachanh, Catrin E Moore, Mayfong Mayxay, Hiroyuki Matsuoka, Paul N Newton
Annals of Clinical Microbiology and Antimicrobials , 2009, DOI: 10.1186/1476-0711-8-24
Abstract: A 53 year-old farmer died with Chromobacterium violaceum septicemia in Laos. A modified oxidase method was used to demonstrate that this violacious organism was oxidase positive. Forensic analysis of the glucose-6-phosphate dehydrogenase genotypes of his family suggest that the deceased patient did not have this possible predisposing condition.C. violaceum infection should be included in the differential diagnosis in patients presenting with community-acquired septicaemia in tropical and subtropical areas. The apparently neglected but simple modified oxidase test may be useful in the oxidase assessment of other violet-pigmented organisms or of those growing on violet coloured agar.Chromobacterium violaceum is a Gram negative facultative anaerobic bacillus, found in soil and stagnant water, that usually has a violet pigmented appearance on agar culture. Since its discovery as a human pathogen in 1927 in Malaysia [1] only ~150 human cases have been reported worldwide, mostly from tropical and subtropical areas. C. violaceum septicaemia has been described in Thailand, with two patients from a province adjacent to Laos [2] and Vietnam [3,4] but, to our knowledge, this is the first patient described in Laos. The disease typically starts with a localized skin infection or localized lymphadenitis after contact with stagnant water or soil and progresses to fulminating septicaemia with necrotizing metastatic lesions and multiple abscesses in the liver, lung, spleen, skin, lymph nodes, and brain, resulting in fatal multiorgan failure [1-10]. The mortality from disseminated C. violaceum infection has been reported to be 60–80% [1-10]. However, the optimal treatment has not been established – combination therapy with co-trimoxazole, chloramphenicol, carbapenems, or fluoroquinolones has been suggested [2,7,9]. Resistance to penicillins and cephalosporins has been commonly reported [3,9,11] and makes therapy while microbiology results are awaited difficult as both antibiotics are
Sepsis por Chromobacterium violaceum pigmentado y no pigmentado Sepsis caused by pigmented and no pigmented Chromobacterium violaceum
Armando Guevara,Marlly Salomón,María Oliveros,Esmirna Guevara
Revista chilena de infectología , 2007,
Abstract: La sepsis por Chromobacterium violaceum es un cuadro clínico rara vez reportado y asociado con una elevada letalidad. Comunicamos un caso fatal de sepsis en un ni o indígena venezolano con 6 a os de edad, quien presentó fiebre y aumento de volumen en la región inguinal derecha y que fuera inicialmente diagnosticado como plastrón apendicular abscedado. La cirugía de apendicetomía reveló un absceso en el músculo psoas derecho, del cual se aisló una cepa pigmentada de C. violaceum, mientras que a partir de hemocultivos se aislaron cepas pigmentada y no pigmentada, simultáneamente, del mismo agente. Se administró tratamiento con imipenem y amikacina pero su condición se deterioró y falleció a los 9 días de su ingreso Chromobacterium violaceum sepsis is rare but associated with a high mortality rate. We report a fatal case of C. violaceum sepsis in a 6 years old Venezuelan indian boy. Clinical manifestations were fever and swelling in the right inguinal region. The initial diagnosis was an appendicular plastron. Appendicectomy was performed and during surgery a right psoas abscess was identified that resulted culture positive for pigmented C. violaceum. Blood cultures were positive for a pigmented and non pigmented C. violaceum strain. Imipenem and amikacin were administered despite of which the child died 9 days after hospital admission
Sepsis por Chromobacterium violaceum pigmentado y no pigmentado
Guevara,Armando; Salomón,Marlly; Oliveros,María; Guevara,Esmirna; Guevara,Milarys; Medina,Laida;
Revista chilena de infectología , 2007, DOI: 10.4067/S0716-10182007000500010
Abstract: chromobacterium violaceum sepsis is rare but associated with a high mortality rate. we report a fatal case of c. violaceum sepsis in a 6 years old venezuelan indian boy. clinical manifestations were fever and swelling in the right inguinal region. the initial diagnosis was an appendicular plastron. appendicectomy was performed and during surgery a right psoas abscess was identified that resulted culture positive for pigmented c. violaceum. blood cultures were positive for a pigmented and non pigmented c. violaceum strain. imipenem and amikacin were administered despite of which the child died 9 days after hospital admission
Sepsis by Chromobacterium violaceum: first case report from Colombia
Díaz Pérez, Julio Alexander;García, Jorge;Rodriguez Villamizar, Laura Andrea;
Brazilian Journal of Infectious Diseases , 2007, DOI: 10.1590/S1413-86702007000400016
Abstract: chromobacterium violaceum is found in tropical and subtropical regions; it is the only chromobacterium species pathogenic for humans. due to its rare presentation, physicians often ignore the importance of this pathogen. we report a fulminant fatal case of bacteremia in a 38-year-old colombian man. the clinical manifestations were fever, thoracic pain, respiratory failure and death. his condition, from the beginning of clinical diagnosis, went into continuous deterioration, till his death, within a few days after the symptoms began. two hemocultures isolated c. violaceum. we conclude that doctors should consider this differential diagnosis in patients with systemic inflammatory response syndrome, with continuous deterioration.
Chromobacterium Violaceum Septicaemia-A Case Report
Rekha Rai*, Vimal Kumar Karnaker, Veena Shetty and Krishnaprasad MS
Al Ameen Journal of Medical Sciences , 2011,
Abstract: Chromobacterium violaceum is a rare human pathogen with a high rate of mortality. Since the first case from Malaysia in 1927, about 150 cases have been reported till 2004 in the world literature [1]. We report a case of septicaemia with bronchopneumonia in a young healthy male
Cultivation conditions for pigment production by Chromobacterium violaceum
Ana Kelly Pitlovanciv,Margot érika Caris,Luismar Marques Porto,Rozangela Curi Pedrosa
Biotemas , 2006,
Abstract: Chromobacterium violaceum is a beta proteobacterium, gram-negative, facultative anaerobe, found in soil, riverbanks and waters of tropical and subtropical regions all around the world. The species produces, through secondary metabolism, several indole pigments derived from tryptophan. Violacein and desoxyviolacein are the most abundant pigments produced by C. violaceum. Previous studies have reported that culture extracts from C. violaceum, containing the pigments, possess important biological properties, such as antitumoral and antibiotic activities. This accounts for the current interest in defining cultivation conditions for the improvement of violacein and other pigment production. Our results showed that violacein production depends on carbon source. The pigment production is stimulated by glycerol, but its production is reduced in the presence of an easily metabolized carbon source, such as glucose or fructose. In addition, the utilization of a solid medium in the presence of glycerol is a better medium for the production of violacein and related pigments by C. violaceum.
Chromobacterium violaceum infection in Brazil. A case report
MARTINEZ, Roberto;VELLUDO, Maria Angeles Sanches L.;SANTOS, Vanda Roseli dos;DINAMARCO, Paula Vanessa;
Revista do Instituto de Medicina Tropical de S?o Paulo , 2000, DOI: 10.1590/S0036-46652000000200008
Abstract: we report the second case of infection with chromobacterium violaceum that occurred in brazil. a farm worker living in the state of s?o paulo presented fever and severe abdominal pain for four days. at hospitalization the patient was in a toxemic state and had a distended and painful abdomen. chest x-ray and abdominal ultrasound revealed bilateral pneumonia and hypoechoic areas in the liver. the patient developed failure of multiple organs and died a few hours later. blood culture led to isolation of c. violaceum resistant to ampicillin and cephalosporins and sensitive to chloramphenicol, tetracyclin, aminoglicosydes, and ciprofloxacin. autopsy revealed pulmonary microabscesses and multiple abscesses in the liver. the major features of this case are generally observed in infections by c. violaceum: rapid clinical course, multiple visceral abscesses, and high mortality. because of the antimicrobial resistance profile of this gram-negative bacillus, for appropriate empirical antibiotic therapy it is important to consider chromobacteriosis in the differential diagnosis of severe community infections in brazil.
Chromobacterium violaceum infection in Brazil. A case report  [cached]
MARTINEZ Roberto,VELLUDO Maria Angeles Sanches L.,SANTOS Vanda Roseli dos,DINAMARCO Paula Vanessa
Revista do Instituto de Medicina Tropical de S?o Paulo , 2000,
Abstract: We report the second case of infection with Chromobacterium violaceum that occurred in Brazil. A farm worker living in the State of S o Paulo presented fever and severe abdominal pain for four days. At hospitalization the patient was in a toxemic state and had a distended and painful abdomen. Chest X-ray and abdominal ultrasound revealed bilateral pneumonia and hypoechoic areas in the liver. The patient developed failure of multiple organs and died a few hours later. Blood culture led to isolation of C. violaceum resistant to ampicillin and cephalosporins and sensitive to chloramphenicol, tetracyclin, aminoglicosydes, and ciprofloxacin. Autopsy revealed pulmonary microabscesses and multiple abscesses in the liver. The major features of this case are generally observed in infections by C. violaceum: rapid clinical course, multiple visceral abscesses, and high mortality. Because of the antimicrobial resistance profile of this Gram-negative bacillus, for appropriate empirical antibiotic therapy it is important to consider chromobacteriosis in the differential diagnosis of severe community infections in Brazil.
Proteomics Analysis of the Effects of Cyanate on Chromobacterium violaceum Metabolism  [PDF]
Rafael A. Baraúna,Alessandra Ciprandi,Agenor V. Santos,Marta S.P. Carepo,Evonnildo C. Gon?alves,Maria P.C. Schneider,Artur Silva
Genes , 2011, DOI: 10.3390/genes2040736
Abstract: Chromobacterium violaceum is a gram-negative betaproteobacterium that has been isolated from various Brazilian ecosystems. Its genome contains the cyn operon, which gives it the ability to metabolize highly toxic cyanate into ammonium and carbon dioxide. We used a proteomics approach to investigate the effects of cyanate on the metabolism of this bacterium. The proteome of cells grown with and without cyanate was compared on 2-D gels. Differential spots were digested and identified by mass spectrometry. The bacterium was able to grow at concentrations of up to 1 mM cyanate. Eighteen spots were differentially expressed in the presence of cyanate, of which 16 were downregulated and only two were upregulated. An additional 12 spots were detected only in extracts of cells unexposed to cyanate, and one was expressed only by the exposed cells. Fourteen spots were identified, corresponding to 13 different proteins. We conclude that cyanate promotes expression of enzymes that combat oxidative stress and represses enzymes of the citric acid cycle, strongly affecting the energetic metabolism of the cell. Other proteins that were under-expressed in bacteria exposed to cyanate are involved in amino-acid metabolism or are hypothetical proteins, demonstrating that cyanate also affects expression of genes that are not part of the cyn operon.
A successful antimicrobial regime for Chromobacterium violaceum induced bacteremia  [cached]
Campbell James I,Lan Nguyen Phu,Qui Phan,Dung Le
BMC Infectious Diseases , 2013, DOI: 10.1186/1471-2334-13-4
Abstract: Background Chromobacterium violaceum is a proteobacterium found in soil and water in tropical regions. The organism rarely causes infection in humans, yet can cause a severe systemic infection by entering the bloodstream via an open wound. Case presentation We recently identified a case of severe bacteremia caused by Chromobacterium violaceum at the Hospital for Tropical Diseases (HTD) in Ho Chi Minh City, Vietnam. Here, we describe how rapid microbiological identification and a combination of antimicrobials was used to successfully treat this life threatening infection in a four-year-old child. Conclusions This case shows the need for rapid diagnosis when there is the suspicion of a puncture wound contaminated with water and soil in tropical regions. We suggest that the aggressive antimicrobial combination used here is considered when this infection is suspected.
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