HELICOBACTER CINAEDI-ASSOCIATED BACTEREMIA AND CELLULITIS IN IMMUNOCOMPROMISED PATIENTS

Objective: To define the clinical spectrum of illness associated with Helicobacter cinaedi infection in the United States and to determine associated epidemiologic risk factors and optimal laboratory methods for recovery of H. cinaedi. Design: A retrospective epidemiologic study of 23 patients with H. cinaedi-associated illness. Patients: 23 patients with H. cinaedi infection identified between January 1982 and August 1990. Most isolates (22 of 23) were from blood; one was from stool. Results: Ages ranged from 24 to 84 years (mean, 44 years). Eighty-three percent of patients were men; 17% were women. Clinical and laboratory data were obtained from 21 patients. Eighteen patients were febrile (15 required hospitalization); cellulitis was reported in 9 patients. Sixty percent were immunocompromised; 45% were reported to be seropositive for human immunodeficiency virus (HIV). For bacteremic patients, positive blood cultures were detected by a slightly elevated growth index in an automated blood culture system; many hospital laboratories had difficulty isolating the organism. Conclusions: Helicobacter cinaedi appears to cause recurrent cellulitis with fever and bacteremia in immunocompromised hosts. Blood cultures from immunocompromised patients with these symptoms may need special handling to isolate H. cinaedi.