Helicobacter cinaedi associated with atypical Raynaud syndrome

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Helicobacter cinaedi associated with atypical Raynaud syndrome

Clémence Beauruelle, Hervé Le Bars, Nolwenn Astruc, Didier Tandé, Rozenn Le Berre, Geneviève Héry-Arnaud

To cite this version:

Clémence Beauruelle, Hervé Le Bars, Nolwenn Astruc, Didier Tandé, Rozenn Le Berre, et al.. He- licobacter cinaedi associated with atypical Raynaud syndrome. Clinical Microbiology and Infection, Elsevier for the European Society of Clinical Microbiology and Infectious Diseases, 2019, 25 (3), pp.324-325. �10.1016/j.cmi.2019.01.001�. �hal-02462862�

Pictures of a Microorganism 1

Helicobacter cinaedi associated with atypical Raynaud 2

syndrome.

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Clémence Beauruelle^{1,2 #}, Hervé Le Bars¹, Nolwenn Astruc³, 4

Didier Tandé¹, Rozenn Le Berre^2,3, Geneviève Héry-Arnaud^1,2 5

Keywords: Helicobacter, Raynaud’s disease, Arteriosclerosis 6

Author affiliations:

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1Département de Bactériologie-Virologie, Hygiène et 8

Parasitologie-Mycologie, Centre Hospitalier Régional 9

Universitaire (CHRU) de Brest, 29238 Brest, France 10

2UMR1078 "Génétique, Génomique Fonctionnelle et 11

Biotechnologies", INSERM, Université de Brest, EFS, IBSAM, 12

29200 Brest, France 13

3Service de Médecine Interne et pneumologie, CHRU Brest, 14

Brest, France.

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#Corresponding author: Clémence Beauruelle, Département de 17

Bactériologie-Virologie, Hygiène et Parasitologie-Mycologie, 18

Hôpital La Cavale Blanche, CHRU de Brest, 29238 Brest, 19

France. [email protected] 20

Tel.: +33(0)298145105 Fax : +33(0)298145149 21

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A 43-year-old immunocompetent woman presented to the 25

emergency department for pseudo Raynaud syndrome. She has 26

already consulted two days before for chest pain without 27

identified etiology. She had a medical history of arrhythmia and 28

currently received fondaparinux for superficial venous 29

thrombosis of the right leg. At the admission, as the 30

examination was normal, no further tests were performed, the 31

patient was discharged, and a follow-up was organized one 32

month later during which three sets of blood cultures were 33

sampled as the patient described night sweats without fever.

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After 6 days incubation, one aerobic blood culture (BD, 35

BACTEC) flagged positive with incurvated Gram negative 36

bacilli (Fig. 1). Because of the Gram strain morphology, a 37

Columbia agar plate was incubated in microaerobic conditions 38

additionally to Columbia and chocolate agar plates incubated 39

with 5% CO2. After 4 days incubation at 37°C, the 40

microaerobic subculture was positive with pinpoint colonies, 41

secondarily forming a swarming thin film, identified as H.

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cinaedi by MALDI-TOF MS (Bruker Daltonics) confirmed by 43

complete 16S rRNA gene sequencing. Minimal Inhibitory 44

Concentrations (MICs) were determined using the E-test®

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method (bioMérieux) for amoxicillin (MIC, 1 mg/L), cefepime 46

(MIC, 0.5 mg/L), ceftriaxone (MIC, 1 mg/L), cefotaxime (MIC, 47

32 mg/L), imipenem (MIC, 0.012 mg/L), levofloxacin (MIC, 48

0.016 mg/L), and tetracycline (MIC, ≤ 0.016 mg/L); To note 49

there are no interpretive criteria for antimicrobial susceptibility 50

testing of H. cinaedi. Considering these results, the absence of 51

recommended guidelines and the general condition of the 52

patient (immunocompetent woman, normal medical 53

examination and normal blood analysis), doxycycline (100 mg 54

twice daily) was initiated for 2 weeks. One month after 55

treatment, outcome was favourable as another three sets of 56

blood culture samples remained negative, and the transthoracic 57

echocardiography reported normal results.

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H. cinaedi has a higher vascular affinity than other 60

Helicobacter species and appears to be closely associated with 61

cardiovascular diseases such as arrhythmia and atherosclerosis 62

as in the present case [1]. It is possibly associated to subclinical 63

symptoms, which could disappear spontaneously although the 64

microorganism is still present.

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Transparency declaration 66

Conflicts of interest: All authors report no conflicts of interest 67

relevant to this article.

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Funding: No external funding was received.

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REFERENCES 71

[1] Khan S, Okamoto T, Enomoto K, Sakashita N, Oyama K, 72

Fujii S, et al. Potential association of Helicobacter cinaedi 73

with atrial arrhythmias and atherosclerosis. Microbiol 74

Immunol 2012;56:145–54. doi:10.1111/j.1348- 75

0421.2012.00421.x.

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