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A young child with acute perforated appendicitis due to Comamonas kerstersii: a rare case report
Hind Bennani1, Assia El Ouarradi1, Asmaa Lamrani Hanchi1
1Faculty of Medicine and Pharmacy of Marrakech Cadi Ayyad University, Microbiology Department, Mohamed VI University Hospital, Marrakech, Morocco.
Abstract:
Comamonas species are rarely associated with human infections. Recent reports found that Comamonas kerstersii was associated with severe diseases such as abdominal infection and bacteremia. However, Comamonas kerstersii may be confused with Comamonas testosteroni using the automatic bacterial identification systems currently available. An 8-year-old boy who had a right iliac fossa pain and classic migration of pain at the temperature of 38.9°C. The positive strain of aerobic and anaerobic bottles of blood cultures was identified. The patient was diagnosed as acute peritonitis and perforated appendix with abdominal abscess. The bacterium was identified by routine methods, MALDI-TOF-MS. The patient was treated with exploratory laparotomy, appendectomy, tube drainage, and prescribing antibiotic treatment. The patient was discharged with complete recovery. The organisms were confirmed as Comamonas kerstersii by MALDI-TOFMS and a combination of the other results. Our findings suggest that Comamonas kerstersii infection occurs most often in association with perforated appendix and bacteremia. We presume that Comamonas kerstersii is an opportunistic pathogen or commensal with the digestive tract and appendix bacteria.
Insights
Comamonas kerstersii, a bacterium rarely causing human infections, was identified in an 8-year-old boy with appendicitis and bacteremia. This case highlights the importance of accurate identification to distinguish it from similar species.
Area of Science:
- Medical Microbiology
- Infectious Diseases
Background:
- Comamonas species are infrequently linked to human infections.
- Comamonas kerstersii has been associated with severe conditions like abdominal infections and bacteremia.
- Distinguishing Comamonas kerstersii from Comamonas testosteroni can be challenging with current automated identification systems.
Observation:
- An 8-year-old boy presented with right iliac fossa pain, fever, and symptoms consistent with acute peritonitis and a perforated appendix with an abdominal abscess.
- Blood cultures were positive for aerobic and anaerobic bacteria.
- The causative bacterium was identified as Comamonas kerstersii using routine methods and Matrix-Assisted Laser Desorption/Ionization-Time of Flight Mass Spectrometry (MALDI-TOF MS).
Findings:
- The patient underwent surgery (exploratory laparotomy, appendectomy, tube drainage) and antibiotic treatment.
- Comamonas kerstersii infection was confirmed in association with a perforated appendix and bacteremia.
- The patient recovered fully after treatment.
Implications:
- Accurate identification of Comamonas kerstersii is crucial, especially in cases of abdominal infections.
- Comamonas kerstersii may act as an opportunistic pathogen or commensal within the digestive tract and appendix.
- This case underscores the potential for Comamonas kerstersii to cause severe infections in humans, particularly in conjunction with gastrointestinal complications.
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