Potential pathogenicity of Inquilinus limosus in a pediatric patient with cystic fibrosis

Pediatr Pulmonol. 2018 Jul;53(7):E21-E23. doi: 10.1002/ppul.24043. Epub 2018 May 23.

Abstract

Presentation: Patient is a 6-year-old male with CF, MRSA colonization, and pancreatic insufficiency that presented with worsening ppFEV1 and systemic symptoms despite multiple interventions. BAL grew NTM, Stenotrophomonas maltophilia, and Inquilinus limosus, a rare organism found in patients with CF.

Course: I. limosus treatment was deferred. Despite treatment of other pathogens, symptoms worsened. I. limosus was targeted with meropenem, amikacin, and ciprofloxacin along with clindamycin for MRSA colonization. Within weeks, symptoms had resolved with ppFEV1 improvement.

Discussion: This case discusses the importance of a rare organism in the CF population. Targeting I. limosus was key to recovery, revealing its potential pathogenicity.

Keywords: Inquilinus limosus; MRSA; cystic fibrosis; infections; nontuberculous mycobacterium.

Publication types

  • Case Reports

MeSH terms

  • Amikacin / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Child
  • Ciprofloxacin / therapeutic use
  • Clindamycin / therapeutic use
  • Cystic Fibrosis / drug therapy
  • Cystic Fibrosis / microbiology*
  • Cystic Fibrosis / physiopathology
  • Gram-Negative Bacterial Infections / drug therapy
  • Gram-Negative Bacterial Infections / microbiology
  • Gram-Negative Bacterial Infections / physiopathology
  • Humans
  • Male
  • Meropenem / therapeutic use
  • Methicillin-Resistant Staphylococcus aureus / drug effects
  • Rhodospirillaceae / drug effects
  • Rhodospirillaceae / pathogenicity*
  • Stenotrophomonas maltophilia / drug effects
  • Virulence

Substances

  • Anti-Bacterial Agents
  • Clindamycin
  • Ciprofloxacin
  • Amikacin
  • Meropenem