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A new emerging oral infection: Raoultella planticola in a boy with haematological malignancy
E Bardellini1, F Amadori2, R F Schumacher3
1Department Oral Medicine and Paediatric Dentistry, Dental Clinic, University of Brescia, p.le Spedali Civili n.1, 25133, Brescia, Italy. elena.bardellini@unibs.it.
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.
