Carnobacterium inhibens isolated in blood culture of an immunocompromised, metastatic cancer patient: a case report and literature review

BMC Infect Dis. 2021 May 1;21(1):403. doi: 10.1186/s12879-021-06095-7.

Abstract

Background: Carnobacterium species are lactic acid-producing Gram-positive bacteria that have been approved by the US Food and Drug Administration and Health Canada for use as a food bio-preservative. The use of live bacteria as a food additive and its potential risk of infections in immunocompromised patients are not well understood.

Case presentation: An 81-year-old male with a history of metastatic prostate cancer on androgen deprivation therapy and chronic steroids presented to our hospital with a 2-week history of productive cough, dyspnea, altered mentation, and fever. Extensive computed tomography imaging revealed multifocal pneumonia without other foci of infection. He was diagnosed with pneumonia and empirically treated with ceftriaxone and vancomycin. Blood cultures from admission later returned positive for Carnobacterium inhibens. He achieved clinical recovery with step-down to oral amoxicillin/clavulanic acid for a total 7-day course of antibiotics.

Conclusions: This is the fourth reported case of bacteremia with Carnobacterium spp. isolated from humans. This case highlights the need to better understand the pathogenicity and disease spectrum of bacteria used in the food industry for bio-preservation, especially in immunocompromised patients.

Keywords: Bacteremia; Carnobacterium inhibens; Carnobacterium species; Case report; Immunocompromised; Sepsis.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Aged, 80 and over
  • Amoxicillin-Potassium Clavulanate Combination / therapeutic use
  • Androgen Antagonists / therapeutic use
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / drug therapy
  • Bacteremia / microbiology*
  • Blood Culture
  • Canada
  • Carnobacterium* / isolation & purification
  • Carnobacterium* / pathogenicity
  • Ceftriaxone / therapeutic use
  • Food Microbiology
  • Gram-Positive Bacterial Infections / blood
  • Gram-Positive Bacterial Infections / drug therapy*
  • Gram-Positive Bacterial Infections / microbiology*
  • Humans
  • Immunocompromised Host
  • Male
  • Pneumonia, Bacterial / drug therapy
  • Pneumonia, Bacterial / microbiology
  • Prostatic Neoplasms / drug therapy
  • Prostatic Neoplasms / microbiology
  • Prostatic Neoplasms / pathology*
  • Vancomycin / therapeutic use

Substances

  • Androgen Antagonists
  • Anti-Bacterial Agents
  • Vancomycin
  • Amoxicillin-Potassium Clavulanate Combination
  • Ceftriaxone

Supplementary concepts

  • Carnobacterium inhibens