Recurrent "Flexispira rappini" bacteremia in an adult patient undergoing hemodialysis: Case report

A blood culture from a 65-year-old febrile man undergoing hemodialysis reve aled, 5 days after inoculation, an unusual gram-negative fusiform rod with darting motility. During another episode of fever 21 days later, this Campy lobacter-like organism was again recovered from three blood cultures and su bcultured under an H-2-enriched microaerobic atmosphere, The organism was c atalase negative and oxidase positive and hydrolyzed urea rapidly. Sodium d odecyl sulfate-polyacrylamide gel electrophoresis analysis of whole-cell pr oteins was indistinguishable from that of "Flexispira rappini" LMG 8738 des cribed by Archer et al. in 1988 (J. R. Archer, S. Romero, A. E. Ritchier, M . E. Ramacher, B. M. Steiner, J. H, Bryner, and R F, Schell, J. Clin. Micro biol. 26:101-105, 1988), The analysis of the 16S ribosomal DNA sequence rev ealed a similarity of 99.3% between the two strains. The patient recovered completely after a 4-week course of meropenem therapy. This is the first re ported case of a recurrent "F. rappini" bacteremia in an adult patient, whi ch confirms that this organism may be an invasive pathogen in immunocomprom ised patients, like other newly described Helicobacter species.