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Saudi Journal of Kidney Diseases and Transplantation
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Table of Contents   
CASE REPORT  
Year : 2018  |  Volume : 29  |  Issue : 5  |  Page : 1220-1222
Myroides odoratimimus urinary tract infection


1 Department of Nephrology, Mazumdar Shaw Medical Center, Narayana Health, Bengaluru, Karnataka, India
2 Academic Research Department, Narayana Hrudayalaya Foundations, Bengaluru, Karnataka, India

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Date of Submission09-Sep-2017
Date of Acceptance10-Oct-2017
Date of Web Publication26-Oct-2018
 

   Abstract 

Myroides species formerly known as Flavobacterium odoratum, a rare clinical isolate often considered as nonpathogenic. Myroides odoratimimus commonly found in the environment and frequently isolated from the immunocompromised patients. The incidence of urinary tract infection (UTI) caused by Myroides species is a rare phenomenon. We describe a rare case of UTI caused by Myroides odoratimimus in an elderly patient.

How to cite this article:
Ahamed I, Annapandian VM, Muralidhara KD. Myroides odoratimimus urinary tract infection. Saudi J Kidney Dis Transpl 2018;29:1220-2

How to cite this URL:
Ahamed I, Annapandian VM, Muralidhara KD. Myroides odoratimimus urinary tract infection. Saudi J Kidney Dis Transpl [serial online] 2018 [cited 2018 Nov 15];29:1220-2. Available from: http://www.sjkdt.org/text.asp?2018/29/5/1220/243957

   Introduction Top


Myroides odoratus and Myroides odratimimus are the two species of genus Myroides. It is a Gram-negative pathogen, commonly found in the environmental pathogens and not a part of human microflora. Myroides species formerly known as Flavobacterium odoratus, since it is rare isolation from humans, often considered as nonpathogenic. Published literature showed most of the Myroides infections are from immunocompromised patients.[1],[2],[3],[4],[5],[6],[7] Very few cases were reported in nonimmunocompromised patients.[8],[9] Here, we describe a case of M. odratimimus isolated from the urine culture of a 74-year-old male.


   Case Report Top


A 74-year-old male was admitted to our hospital with the complaints of vomiting and irrelevant talk over the past five days. He was diagnosed to have hyperkalemia and severe renal failure outside and referred to our hospital for further evaluation. At presentation, his creatinine was 10.40 mg/dL, and he had severe hyperkalemia with electrocardiograph changes. Physical examination was unremarkable except poor sensorium with prolonged reaction time. The trans thoracic echocardiography report showed rheumatic heart disease with mild mitral stenosis. Diagnostic cerebrospinal fluid tap was negative for bacteriology. He was initiated on hemodialysis given severe renal failure with hyperkalemia. Serology reports were negative for hepatitis B surface antigen, hepatitis C antibody, human immunodeficiency virus, Leptospira, and H1N1 flu virus. His urine culture showed the growth of M. odoratimimus and this pathogen was resistant to all antibiotics tested [Table 1].
Table 1: In vitro susceptibility of Myroides odoratimimus.

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   Discussion Top


A 74-year-old male patient was admitted into the intensive care unit and treated with mechanical ventilation. After initiating hemodialysis, he was responded well. Hence, he was extubated and shifted to ward. After shifting to ward, he developed a fever for which he was investigated. His urine culture had shown the growth of M. odoratimimus, which was resistant to all antibiotics tested [Table 1]. The strain was identified by Matrix-assisted laser desorption ionization time-of-flight mass spectrometry.

There are limited published cases of Myroides species available in the literature [Table 2]. In several occasions, Myroides were described in immunocompromised individuals. Soft-tissue infections were reported previously with six cases,[1],[2],[3],[4],[5],[6] which include cellulitis associated with bacteremia (n = 4), soft-tissue infection with septic shock and pneumonia (n = 1) and necrotizing fasciitis (n = 1). One study described a case of M. odoratimimus from a pig bite which caused osteolytic lesions on the right tibia.[7] Another study reported myroides bacteremia in a diabetic individual.[8]
Table 2: Cases of Myroides species reported in the literature.

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One fatal case report of pericardial effusion due to M. odoratimimus was reported from India.[9] There were two documented M. odoratimimus involved nosocomial outbreak of urinary tract infections in Turkish[10] and Tunisia.[11] The details of published Myroides species are given in [Table 2].

In the present case, M. odoratimimus was isolated from urine culture of a 74-year-old male. Treatment was problematic since the organism was pan-resistant. The patient did not respond to antibiotic therapy, his clinical condition gradually deteriorated with persistent fever, and finally, the patient was succumbed to death.


   Conclusion Top


We report a case of urinary tract infection with M. odoratimimus in an elderly patient. Since the patient had multiple complications, the specific cause of death was not ascertained. It would be beneficial considering Myroides in differential diagnosis, especially when the patient is nonresponsive to regular antibiotics treatment.

Conflict of interest: None declared.

 
   References Top

1.
Hsueh PR, Wu JJ, Hsiue TR, Hsieh WC. Bacteremic necrotizing fasciitis due to Flavobacterium odoratum. Clin Infect Dis 1995;21:1337-8.  Back to cited text no. 1
    
2.
Bachman KH, Sewell DL, Strausbaugh LJ. Recurrent cellulitis and bacteremia caused by Flavobacterium odoratum. Clin Infect Dis 1996;22:1112-3.  Back to cited text no. 2
    
3.
Green BT, Green K, Nolan PE. Myroides odoratus cellulitis and bacteremia: Case report and review. Scand J Infect Dis 2001;33:932-4.  Back to cited text no. 3
    
4.
Motwai B, Krezolek D, Symeonides S, Khayr W. Myroides odoratum cellulitis and bacteremia: A case report. Infect Dis Clin Pract 2004;12:343-44.  Back to cited text no. 4
    
5.
Bachmeyer C, Entressengle H, Khosrotehrani K, et al. Cellulitis due to Myroides odoratimimus in a patient with alcoholic cirrhosis. Clin Exp Dermatol 2008;33:97-8.  Back to cited text no. 5
    
6.
Benedetti P, Rassu M, Pavan G, Sefton A, Pellizzer G. Septic shock, pneumonia, and soft tissue infection due to Myroides odoratimimus: Report of a case and review of Myroides infections. Infection 2011;39:161-5.  Back to cited text no. 6
    
7.
Maraki S, Sarchianaki E, Barbagadakis S. Myroides odoratimimus soft tissue infection in an immunocompetent child following a pig bite: Case report and literature review. Braz J Infect Dis 2012;16:390-2.  Back to cited text no. 7
    
8.
Endicott-Yazdani TR, Dhiman N, Benavides R, Spak CW. Myroides odoratimimus bacteremia in a diabetic patient. Proc (Bayl Univ Med Cent) 2015;28:342-3.  Back to cited text no. 8
    
9.
Prateek S, Gupta P, Mittal G, Singh AK. Fatal case of pericardial effusion due to Myroides odoratus: A Rare case report. J Clin Diagn Res 2015;9:DD01-2.  Back to cited text no. 9
    
10.
Yağci A, Cerikçioğlu N, Kaufmann ME, et al. Molecular typing of Myroides odoratimimus (Flavobacterium odoratum) urinary tract infections in a Turkish hospital. Eur J Clin Microbiol Infect Dis 2000;19:731-2.  Back to cited text no. 10
    
11.
Ktari S, Mnif B, Koubaa M et al. Nosocomial outbreak of Myroides odoratimimus urinary tract infection in a Tunisian hospital. J Hosp Infect 2012;80:77-81.  Back to cited text no. 11
    

Top
Correspondence Address:
Dr. Ishthiaque Ahamed
Department of Nephrology, Mazumdar Shaw Medical Center Narayana Health, Bengaluru - 560 099, Karnataka
India
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DOI: 10.4103/1319-2442.243957

PMID: 30381524

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    Abstract
   Introduction
   Case Report
   Discussion
   Conclusion
    References
    Article Tables
 

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