2022 Volume 71 Issue 3 Pages 538-543
We encountered a case of bloodstream disease caused by Trueperella bernardiae, which is the second case in Japan. The patient was a woman in her 80s, with a medical history of dementia, disuse syndrome after cerebral infarction, and aspiration pneumonia. She was admitted to our hospital with fever, respiratory failure, and impaired consciousness, and she was diagnosed as having left obstructive pyelonephritis and associated septic shock. On the same day, a transurethral stent was placed, and a renal pelvis sample and two sets of blood culture samples were collected. Proteus mirabilis, methicillin-resistant Staphylococcus aureus, and coryneform gram-positive rods were detected in the renal pelvis sample. In the blood culture, coryneform gram-positive rods were detected in three of four cell cultures on the 5th day of culture, and the catalase test was negative for such coryneform gram-positive rods. Therefore, VITEK MS was performed and the blood culture was identified as T. bernardiae. Later, a detailed examination of the coryneform gram-positive bacillus derived from the renal pelvis sample revealed that it was catalase-negative and had biochemical properties consistent with those of the blood-derived strain, suggesting the bloodstream with the urinary tract as the invasion route of T. bernardiae. Whenever coryneform gram-positive bacillar cells are detected in a severe infectious disease or sterile material, it is important to perform a catalase test, keeping this bacterium in mind. The patient received tazobactam/piperacillin from the 1st day of illness and was discharged from the hospital on the 26th day of illness.
