COMPLICATIONS OF BACTEREMIA DUE TO STOMATOCOCCUS-MUCILAGINOSUS IN NEUTROPENIC CHILDREN

Stomatococcus mucilaginosus, a normal inhabitant of the human oral cav ity and upper respiratory tract, can cause fatal sepsis and meningitis in neutropenic patients. We identified eight cases of bacteremia due to S. mucilaginosus in children with cancer, of whom five developed co mplications despite receiving appropriate antibiotics. At the time cul tures were positive, seven patients had profound neutropenia (< 100 ne utrophils and band forms/mm3) and four had mucositis; five had central venous catheters. In two cases. there was unequivocal evidence of cat heter-related sepsis. Bacteremia was eradicated in all patients within 48 hours after initiation of antibiotics. Despite prompt instigation of effective antibiotic therapy, the complication rates in this series were high: septic shock (50%). pneumonia (50%), dermatologic manifest ations (38%), altered neurological status (25%), meningitis (13%), and adult respiratory distress syndrome (13%). No fatalities were attribu table to S. mucilaginosus infection. These cases illustrate the virule nce of S. mucilaginosus organisms in neutropenic children and suggest a substantial risk of sequelae even when adequate antibiotic therapy i s given.