A new emerging oral infection: Raoultella planticola in a boy with haematological malignancy

Eur Arch Paediatr Dent. 2017 Jun;18(3):215-218. doi: 10.1007/s40368-017-0279-7. Epub 2017 Mar 27.

Abstract

Background: Oral mucositis is a common complication in pediatric cancer patients, affecting up to 80% of children. Due to neutropenia and disruption of the mucosal barrier, chemotherapy-induced oral mucositis is often complicated by super-infections.

Case report: A 16-years old male with stage 3 Burkitt's lymphoma developed chemotherapy induced oral mucositis grade 3 (according to WHO scale). Ulcers were quickly growing (reaching a maximum diameter of 3 cm) and became greyish in colour, resulting in dysphagia and pain. A swab of the lesions was taken and microbiological tests were performed. The sample grew for Raoultella planticola, an encapsulated Gram-negative bacterium whose full pathogenic potential still needs to be defined.

Treatment: The patient received antibiotic combination therapy with Amikacin and Ceftazidime for 8 days. Complete healing of the lesions and resolution of the symptoms were reached and he completed his antineoplastic therapy without further complications.

Follow-up: Twelve months after the infection, he is alive and well, with no oral complaints.

Conclusion: This is the first report of a Raoultella planticola infection in a patient with chemotherapy induced oral mucositis. This type of infection must be added to the list of organisms to be considered when caring for these patients.

Keywords: Anti-neoplastic agents; Infection; Oral ulcer.

Publication types

  • Case Reports

MeSH terms

  • Adolescent
  • Amikacin / administration & dosage
  • Amikacin / therapeutic use
  • Anti-Bacterial Agents / administration & dosage
  • Anti-Bacterial Agents / therapeutic use
  • Burkitt Lymphoma / complications*
  • Ceftazidime / administration & dosage
  • Ceftazidime / therapeutic use
  • Drug Therapy, Combination
  • Enterobacteriaceae Infections / drug therapy
  • Enterobacteriaceae Infections / etiology*
  • Enterobacteriaceae Infections / microbiology
  • Enterobacteriaceae*
  • Humans
  • Male
  • Stomatitis / drug therapy
  • Stomatitis / etiology*
  • Stomatitis / microbiology

Substances

  • Anti-Bacterial Agents
  • Amikacin
  • Ceftazidime