Modern Rheumatology

, Volume 21, Issue 6, pp 691–695 | Cite as

Leuconostoc bacteremia in a patient with amyloidosis secondary to rheumatoid arthritis and tuberculosis arthritis

  • JeongHwan Shin
  • Minyoung HerEmail author
  • Chisook Moon
  • Dongyook Kim
  • SangHeon Lee
  • SooJin Jung
Case Report


Leuconostoc infections are rare and usually occur in immunocompromised patients. This report describes a case of Leuconostoc lactis bacteremia in a patient with coexisting rheumatoid arthritis and tuberculosis arthritis. A disrupted gastrointestinal barrier due to gastrointestinal amyloidosis in long-standing rheumatoid arthritis and tuberculosis arthritis could be a risk factor for Leuconostoc bacteremia. Despite aggressive antibiotic treatment, the patient progressed to septic shock and multi-organ failure. The fatal course might have been caused by rapid progression of gastrointestinal pathology, which could be a risk factor for Leuconostoc bacteremia.


Leuconostoc lactis Amyloidosis Rheumatoid arthritis Tuberculosis 


Conflict of interest



  1. 1.
    Handwerger S, Horowitz H, Coburn K, Kolokathis A, Wormser GP. Infection due to Leuconostoc species: six cases and review. Rev Infect Dis. 1990;12:602–10.PubMedCrossRefGoogle Scholar
  2. 2.
    Rogosa M, Sharpe ME. Species differentiation of human vaginal lactobacilli. J Gen Microbiol. 1960;23:197–201.PubMedGoogle Scholar
  3. 3.
    Yamazaki R, Mori T, Sugita K, Aisa Y, Ikeda Y, Okamoto S. Leuconostoc septicemia in a neutropenic patient with acute myelogenous leukemia relapsed after allogeneic peripheral blood stem cell transplantation. Transpl Infect Dis. 2009;11:94–5.PubMedCrossRefGoogle Scholar
  4. 4.
    Espinoza R, Kusne S, Pasculle AW, Wada S, Fung J, Rakela J. Leuconostoc bacteremia after liver transplantation: another cause of vancomycin resistant gram-positive infection. Clin Transpl. 1997;11:322–4.Google Scholar
  5. 5.
    Hochberg MC, Chang RW, Dwosh I, Lindsey S, Pincus T, Wolfe F. The American College of Rheumatology 1991 revised criteria for the classification of global functional status in rheumatoid arthritis. Arthritis Rheum. 1992;35:498–502.PubMedCrossRefGoogle Scholar
  6. 6.
    Kim JH, Lee JY, Kim HR, Heo KW, Park SK, Lee JN, et al. Acute lymphadenitis with cellulitis caused by Staphylococcus lugdunensis. Korean J Lab Med. 2008;28:196–200.PubMedCrossRefGoogle Scholar
  7. 7.
    Chun J, Lee JH, Jung Y, Kim M, Kim S, Kim BK, et al. Eztaxon: a web-based tool for the identification of prokaryotes based on 16S ribosomal RNA gene sequences. Int J Syst Evol Microbiol. 2007;57:2259–61.PubMedCrossRefGoogle Scholar
  8. 8.
    Florescu D, Hill L, Sudan D, Iwen PC. Leuconostoc bacteremia in pediatric patients with short bowel syndrome: case series and review. Pediatr Infect Dis J. 2008;27:1013–9.PubMedCrossRefGoogle Scholar
  9. 9.
    Bernaldo de Quiros JC, Munoz P, Cercenado E, Hernandez Sampelayo T, Moreno S, Bouza E. Leuconostoc species as a cause of bacteremia: two case reports and a literature review. Eur J Clin Microbiol Infect Dis. 1991;10:505–9.PubMedCrossRefGoogle Scholar
  10. 10.
    Wakhlu A, Krisnani N, Hissaria P, Aggarwal A, Misra R. Prevalence of secondary amyloidosis in Asian North Indian patients with rheumatoid arthritis. J Rheumatol. 2003;30:948–51.PubMedGoogle Scholar
  11. 11.
    Ebert EC, Nagar M. Gastrointestinal manifestations of amyloidosis. Am J Gastroenterol. 2008;103:776–87.PubMedCrossRefGoogle Scholar
  12. 12.
    Lachmann HJ, Goodman HJ, Gilbertson JA, Gallimore JR, Sabin CA, Gillmore JD, Hawkins PN. Natural history and outcome in systemic AA amyloidosis. N Engl J Med. 2007;356:2361–71.PubMedCrossRefGoogle Scholar
  13. 13.
    Malhotra P, Agarwal R, Awasthi A, Jindal SK, Srinivasan R. How long does it take for tuberculosis to cause secondary amyloidosis? Eur J Intern Med. 2005;16:437–9.PubMedCrossRefGoogle Scholar
  14. 14.
    Ishiyama K, Yamazaki H, Senda Y, Yamauchi H, Nakao S. Leuconostoc bacteremia in three patients with malignancies. J Infect Chemother. 2010 (Epub ahead of print).Google Scholar
  15. 15.
    Ruoff KL, Kuritzkes DR, Wolfson JS, Ferraro MJ. Vancomycin-resistant gram-positive bacteria isolated from human sources. J Clin Microbiol. 1988;26:2064–8.PubMedGoogle Scholar

Copyright information

© Japan College of Rheumatology 2011

Authors and Affiliations

  • JeongHwan Shin
    • 1
  • Minyoung Her
    • 2
    Email author
  • Chisook Moon
    • 3
  • Dongyook Kim
    • 2
  • SangHeon Lee
    • 4
  • SooJin Jung
    • 5
  1. 1.Department of Laboratory Medicine and Paik Institute for Clinical ResearchInje University College of MedicineBusanSouth Korea
  2. 2.Division of Rheumatology, Department of Internal Medicine, Pusan Paik HospitalInje UniversityBusanSouth Korea
  3. 3.Division of Infection, Department of Internal Medicine, Pusan Paik HospitalInje UniversityBusanSouth Korea
  4. 4.Division of Gastroenterology, Department of Internal Medicine, Pusan Paik HospitalInje UniversityBusanSouth Korea
  5. 5.Department of Pathology, Pusan Paik HospitalInje UniversityBusanSouth Korea

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