An unusual presentation of Pseudomonas citronellolis bacteraemia and Campylobacter gastroenteritis infection in a human – a case report and literature review
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Introduction. Pseudomonas citronellolis is an unusual pathogen in humans and has not been extensively described in the scientific literature. Herein, we present a case of bacteremia and septic shock due to Pseudomonas citronellolis following Campylobacter species gastroenteritis in a patient with immunosuppression.
Case Presentation. An 80-year-old man with myeloproliferative disorder on ruxolitinib presented with several days of worsening abdominal pain, which rapidly developed into septic shock with multi-organ failure and explosive diarrhea. Gram-negative bacilli observed on Gram staining of his blood culture broth were later identified as Pseudomonas citronellolis and Bacteroides thetaiotaomicron . Repeated abdominal imaging revealed no evidence of intestinal perforation or megacolon. In addition, stool PCR was positive for Campylobacter species. His clinical course improved after 14 days of meropenem with complete resolution of his symptoms and organ failure.
Conclusion. P. citronellolis is a rare infection in humans. We postulate that Janus Associated Kinase (JAK) inhibition in myeloproliferative disorders heightened this patient’s risk of bacterial translocation and severe illness in the setting of Campylobacter gastroenteritis. P. citronellolis may be identified more frequently as a pathogen in humans as more advanced diagnostic technologies become increasingly available in clinical microbiology.
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The authors have satisfactorily addressed my previous comments.
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The authors have appropriately addressed the reviewers’ comments. This manuscript can be accepted for publication.
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Please rate the quality of the presentation and structure of the manuscript
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To what extent are the conclusions supported by the data?
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Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
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Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
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Comments to Author
1. Please adjust keywords based on MeSH. 2. Please add ethical code in text body. 3. Please discuss more on alarming results of this study in discussion section. 4. Minor spacing problems exist between the words in some parts of the text. 5. Recheck all numbers in the text, to ensure their accuracy. 6. Use following studies performed on Campylobacter in introduction or discussion section and add related references (including 1. Anvarinejad M, Amin Shahidi M, Pouladfar GR, Dehyadegari MA, Mardaneh J. Campylobacter jejuni Bacteremia in a Patient With Acute Lymphocytic Leukemia. Iran Red Crescent Med J. 2016;18(6):e23992.
Please rate the quality of the presentation and structure of the manuscript
Very good
To what extent are the conclusions supported by the data?
…Comments to Author
1. Please adjust keywords based on MeSH. 2. Please add ethical code in text body. 3. Please discuss more on alarming results of this study in discussion section. 4. Minor spacing problems exist between the words in some parts of the text. 5. Recheck all numbers in the text, to ensure their accuracy. 6. Use following studies performed on Campylobacter in introduction or discussion section and add related references (including 1. Anvarinejad M, Amin Shahidi M, Pouladfar GR, Dehyadegari MA, Mardaneh J. Campylobacter jejuni Bacteremia in a Patient With Acute Lymphocytic Leukemia. Iran Red Crescent Med J. 2016;18(6):e23992.
Please rate the quality of the presentation and structure of the manuscript
Very good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes
-
Comments to Author
1. In this study, the authors present a case of bacteremia and septic shock due to Pseudomonas citronellolis following Campylobacter species gastroenteritis in a patient with immunosuppression. 2. Results are well presented. There is just a few minor things that are explained well and need to be revised, e.g identification of blood cultures need to be clarified. 3. Otherwise, the style and organization of the paper communicates and represents key findings in the manuscript Title: An Unusual Presentation of Pseudomonas citronellolis Bacteremia and Campylobacter Gastroenteritis Infection in a Human - A Case Report and Literature Review Comments: - 1. Line 4 - ..…following Camylobacter species….it should be Campylobacter with a "p" 2. Line 8 - The authors talk about Blood cultures that grew gram …
Comments to Author
1. In this study, the authors present a case of bacteremia and septic shock due to Pseudomonas citronellolis following Campylobacter species gastroenteritis in a patient with immunosuppression. 2. Results are well presented. There is just a few minor things that are explained well and need to be revised, e.g identification of blood cultures need to be clarified. 3. Otherwise, the style and organization of the paper communicates and represents key findings in the manuscript Title: An Unusual Presentation of Pseudomonas citronellolis Bacteremia and Campylobacter Gastroenteritis Infection in a Human - A Case Report and Literature Review Comments: - 1. Line 4 - ..…following Camylobacter species….it should be Campylobacter with a "p" 2. Line 8 - The authors talk about Blood cultures that grew gram positive rods, this is incorrect, because gram positive rods can only be observed under a light microscope after gram staining rather than being grown on Blood agar. So, the authors need to rewrite the statement and clarify how they observed the gram positive rods. 3. Line 25 - Spelling and consistency in writing the Campylobacter throughout the manuscript 4. Line 47- were the piperacillin-tazobactam and azithromycin 1stline treatment? -this needs to be clear. 5. Line 49- …..blood cultures grew gram-negative rods, this is a repeating statement that needs to be corrected as indicated above 6. Line 53- Antibiotics "treatment" were broadened 7. Lines 81 -83 have obvious mistakes, including the reference, typo, and bold text/s 8. Line 86 - Campylobacter consistency that need to be corrected
Please rate the quality of the presentation and structure of the manuscript
Very good
To what extent are the conclusions supported by the data?
Strongly support
Do you have any concerns of possible image manipulation, plagiarism or any other unethical practices?
No
Is there a potential financial or other conflict of interest between yourself and the author(s)?
No
If this manuscript involves human and/or animal work, have the subjects been treated in an ethical manner and the authors complied with the appropriate guidelines?
Yes