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Volume 22, Number 3—March 2016
Synopsis

Methylotroph Infections and Chronic Granulomatous Disease

E. Liana FalconeComments to Author , Jennifer R. Petts, Mary Beth Fasano, Bradley Ford, William M. Nauseef, João Farela Neves, Maria João Simões, Millard L. Tierce, M. Teresa de la Morena, David E. Greenberg, Christa S. Zerbe, Adrian Zelazny, and Steven M. Holland
Author affiliations: National Institutes of Health, Bethesda, Maryland, USA (E.L. Falcone, C.S. Zerbe, A.M. Zelazny, S.M. Holland); University of Iowa Hospital and Clinics, Iowa City, Iowa, USA (J.R. Petts, M.B. Fasano, B. Ford, W.M. Nauseef); Veterans Administration Medical Center, Iowa City (W.M. Nauseef); Centro Hospitalar de Lisboa Central, Lisbon, Portugal (J.F. Neves); Instituto Nacional de Saúde Dr. Ricardo Jorge, Lisbon (M.J. Simões); Detroit Medical Center, Detroit, Michigan, USA (M.L. Tierce IV); University of Texas Southwestern Medical Center, Dallas, Texas, USA (M.T. de la Morena, D.E. Greenberg)

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Table

Summary of methylotroph infections in patients with chronic granulomatous disease*

Patient no., reference Patient age, y/sex CGD genetics† Clinical findings Microbiological findings Treatment‡ Outcome
1 (this study) 1/F Autosomal recessive (NCF2 c.304C>T; p.R102X) Pneumonia, cervical lymphadenitis Methylobacterium lusitanum (lung),
Serratia marcescens (lymph node) CRO/CLI/ITZ, HSCT Recovered
2 (this study) 19/M X-linked
(CYBB intragenic deletion) Necrotizing cervical lymphadenitis Granulibacter bethesdensis;Staphylococcus epidermidis VAN/CRO, CFD/DOX/RIF Recovered
3 (this study) 16/M X-linked
(CYBB 13-exon deletion) Meningitis G. bethesdensis MEM/CIP/AMK/DOX/TEC/VCZ,
MEM/CIP/AMK/DOX/CSP/LAMB/LZD/RIF/INH/CLR Died
4 (this study) 9/M X-linked
(CYBB point mutation; exon 10) Cervical abscess, lymphadenitis Acidomonas methanolica TZP/VAN/LAMB/CIP, MEM/VAN/LAMB/CIP, CIP/VCZ/TMPSMX/ IFN-γ, HSCT Recovered
5 (this study) 36/M X-linked
(CYBB c.1139 G>A; p.W380X) Multifocal lymphadenitis G. bethesdensis;S. epidermidis VAN/CRO, CRO/DOX/TMPSMX/ITZ Still receiving treatment as of 2015
6 (4) 10/M X-linked
(CYBB p.Arg226X) Necrotizing cervical lymphadenitis A. methanolica TMPSMX/CRO/DOX, TMPSMX/RFB/GEN Recovered
7 (5) 10/M X-linked Bacteremia G. bethesdensis TMPSMX/CAZ/MTZ/LZD/VCZ Died
8 (6) 39/M X-linked Necrotizing cervical, mediastinal, axillary lymphadenitis G. bethesdensis MEM/DOX, CRO/DOX
9 (6) 36/M X-linked Multifocal necrotizing lymphadenitis, splenic lesions,
ascites G. bethesdensis MEM/TMPSMX/ITZ, MEM/TMPSMX/VCZ/TOB, CRO/TMPSMX/IFN-γ, CPD/DOX/TMPSMX/IFN-γ, splenectomy/TGC Recovered
10 (6) 13/M X-linked Necrotizing thoracic lymphadenitis G. bethesdensis,
S. epidermidis,
Candida glabrata,
Streptococcus mitis group MEM/VCZ, CRO/TOB/DOX/VCZ, CRO, DOX, CRO, CFD Recovered
11 (6) 17/M X-linked Necrotizing cervical and mediastinal lymphadenitis G. bethesdensis LVX, DOX, lymph node excision Recovered
12 (6) 37/M X-linked Necrotizing supraclavicular lymphadenitis,
splenic and liver lesions G. bethesdensis CRO/GEN/VAN, CRO/DOX/TMPSMX, CFD/ DOX/TMPSMX, DOX/TMPSMX Recovered

*AMK, amikacin; CAZ, ceftazidime; CFD, cefdinir; CGD, chronic granulomatous disease; CLI, clindamycin; CLR, clarithromycin; CIP, ciprofloxacin; CPD, cefpodoxime; CRO, ceftriaxone; CSP, caspofungin; CYBB, cytochrome b-245, β polypeptide; DOX, doxycycline; GEN, gentamicin; HSCT, hematopoietic stem cell transplant; IFN-γ, interferon- γ; INH, isoniazid; ITZ, itraconazole; LAMB, liposomal amphotericin B; LVX, levofloxacin; LZD, linezolid; MEM, meropenem; MTZ, metronidazole; NCF2, neutrophil cytosolic factor 2; RFB, rifabutin; RIF, rifampin; TEC, teicoplanin; TGC, tigecycline; TMPSMX, trimethoprim/sulfamethoxazole; TOB, tobramycin; VAN, vancomycin; VRZ, voriconazole.
†Information in parentheses indicates, when known, the mutation that led to CGD.
‡Slashes separate drugs in the same regimen; commas separate regimens.

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References
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Page created: February 18, 2016
Page updated: February 18, 2016
Page reviewed: February 18, 2016
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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