Recurrent granulibacter bethesdensis infections and chronic granulomatous disease

Abstract

Chronic granulomatous disease (CGD) is characterized by frequent infections, most of which are curable. Granulibacter bethesdensis is an emerging pathogen in patients with CGD that causes fever and necrotizing lymphadenitis. However, unlike typical CGD organisms, this organism can cause relapse after clinical quiescence. To better define whether infections were newly acquired or recrudesced, we use comparative bacterial genomic hybridization to characterize 11 isolates obtained from 5 patients with CGD from orth and entral America. Genomic typing showed that 3 atients had recurrent infection months to years after apparent linical cure. Two patients were infected with the same train as previously isolated, and 1 was infected with a enetically istinct strain. This organism is multidrug resistant, nd therapy required surgery and combination ntimicrobial drugs, including long-term ceftriaxone. G. bethesdensis causes necrotizing lymphadenitis in CGD, which may recur or relapse.