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

• Published in: European archives of paediatric dentistry 2017-06, Vol.18 (3), p.215-218
• Main Authors: Bardellini, E., Amadori, F., Schumacher, R. F., Foresti, I., Majorana, A.
• Format: Article
• Language: English
• Subjects: Adolescent; Amikacin - administration & dosage; Amikacin - therapeutic use; Anti-Bacterial Agents - administration & dosage; Anti-Bacterial Agents - therapeutic use; Antibiotics; Bacteria; Bacterial infections; Blood cancer; Burkitt Lymphoma - complications; Cancer therapies; Case Report; Case reports; Ceftazidime - administration & dosage; Ceftazidime - therapeutic use; Chemotherapy; Dentistry; Disease prevention; Drug dosages; Drug resistance; Drug Therapy, Combination; Enterobacteriaceae; Enterobacteriaceae Infections - drug therapy; Enterobacteriaceae Infections - etiology; Enterobacteriaceae Infections - microbiology; Humans; Lesions; Lymphoma; Male; Medicine; Mortality; Mucositis; Nosocomial infections; Pathogens; Patients; Pediatrics; Poisoning; Stomatitis - drug therapy; Stomatitis - etiology; Stomatitis - microbiology; Ulcers; Virulence
• ISSN: 1818-6300; 1996-9805
• DOI: 10.1007/s40368-017-0279-7

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.