Curtobacterium albidum/citreum bacteremia in an intensive care unit patient: The first case report

A 70-year-old man was admitted to a local hospital complaining of fever for 3 days. After 8 days of hospitalization, his platelet count began to decrease, his respiratory rate increased, and he was transferred to the intensive care unit of our hospital. His vital signs upon admission were as follows: Glasgow Coma Scale score, 10 (E3V1M6); pulse, 118 bpm; blood pressure, 119/68 mmHg; respiratory rate, 26/min; peripheral capillary oxygen saturation, 99% on 5 L/min of oxygen; as well as generalized jaundice. Blood cultures obtained on day one were negative, and the patient's general condition gradually improved. However, on day 20, gram-positive rods were isolated from two of the four blood cultures obtained (aerobic bottles only). Vancomycin was initiated, and the following day the infecting organism was identified as Curtobacterium albidum/citreum. However, a second blood culture obtained on day 22 was still positive. Bone marrow examination confirmed a diagnosis of diffuse large B-cell lymphoma, and chemotherapy was initiated on day 25; however, the patient's general condition deteriorated, and he died on day 26. 16S rRNA analysis revealed a 99% match with C. citreum, a Corynebacterium-like gram-positive rod that colonizes rice and other crops. However, only a few human infections have been reported, including one previous report of possible catheter-related bacteremia based on recovery from a single aerobic bottle. To our knowledge, no prior case of probable clinically significant Curtobacterium bacteremia supported by repeated recovery from separate blood-culture collections has been documented. The number of reports is likely to increase as the use of matrix-assisted laser desorption ionization time-of-flight mass spectrometry becomes more widespread. C. albidum/citreum can cause nosocomial infections in immunocompromised patients, and further studies are required to determine the optimal therapeutic agents.