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Abstract: FR-PO777

Cardiac Tamponade Secondary to Campylobacter Fetus Infection in a Kidney Transplant Recipient

Session Information

Category: Transplantation

  • 2102 Transplantation: Clinical

Authors

  • Obata, Shota, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan
  • Mochida, Yasuhiro, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan
  • Hidaka, Sumi, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan
  • Kobayashi, Shuzo, Shonan Kamakura Sogo Byoin, Kamakura, Kanagawa, Japan
Introduction

Campylobacter fetus (C.fetus) is known to cause diarrhea as well as bacteremia, meningitis, osteomyelitis, mycotic aneurysms, and pericarditis. Immunocompromised patients are at high risk of developing systemic symptoms. We present the first case of cardiac tamponade secondary to C.fetus in a kidney transplant patient and review the outcome of C. fetus infection in organ-transplanted patients.

Case Description

A 61-year-old man with a history of ABO-compatible living-donor kidney transplantation presented to the Emergency Department with altered mental status and fever. Four months before the presentation, he complained of fatigue with mildly elevated C-reactive protein. Although CT chest with contrast showed a small amount of pericardial effusion, he was carefully monitored without further workup. A week ago, he gradually felt weak and developed a fever. On the presentation day, he was unable to move and call an ambulance. On arrival, he was confused and hypotensive. A physical exam showed elevated jugular venous distension with a muffled heart sound. Transthoracic ultrasound demonstrated pericardial effusion with the diastolic collapse of the right ventricular. Pericardiocentesis was performed, draining 200 mL of purulent fluid. He was diagnosed with bacterial pericarditis and started on meropenem and teicoplanin. The culture returned positive for C.fetus. Then antibiotics were switched to ampicillin according to the susceptibility. He was discharged on 31 hospital-day to a nursing home for rehabilitation.

Discussion

We experienced the first case of cardiac tamponade due to C.fetus infection in a patient with a kidney transplant. C.fetus is known to colonize cattle and sheep and can be transmitted to humans via undercooked meat. Of note, this patient stated that he ate raw cattle liver and meat at a restaurant several months before the presentation. We also reviewed the five cases of C.fetus infection in patients with organ transplants. Four out of five cases responded to antibiotics, whereas one died due to sepsis. The presentations varied from bacteremia, meningitis to splenic abscesses. Interestingly, none of the five cases reported any history of exposure to cattle or sheep or raw meat intake. Nevertheless, this case reminds us of the need for guidance regarding raw meat consumption in patients who take immunosuppressive medications.