lmo Laboratory Medicine Online Lab Med Online 2093-6338 The Korean Society for Laboratory Medicine 10.3343/lmo.2018.8.1.34 lmo-8-34 Original Article A Case of Biliary Sepsis by Dysgonomonas capnocytophagoides MinSungheeM.D. 1 LeeHye-YoungM.D. 1 ChangJeong-HyunM.D. 1 SungHeungsupM.D. 1 KimMi-NaM.D. ∗ 1 BaeMi-HyunM.D. 2 KimMyung-HwanM.D. 3 Department of Laboratory Medicine, University of Ulsan College of Medicine and Asan Medical Center, Seoul, Korea Department of Laboratory Medicine, Hanyang University Guri Hospital, Hanyang University College of Medicine, Guri, Korea Division of Gastroenterology, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea Corresponding author: Mi-Na Kim Department of Laboratory Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songpa-gu, Seoul 05505, Korea Tel: +82-2-3010-4511, Fax: +82-2-478-0884, E-mail: mhkim@amc.seoul.kr 012018 19012018 813438 31052017 26082017 5092017 Copyright © 2018 The Korean Society for Laboratory Medicine 2018 This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Dysgonomonas capnocytophagoides is a gram-negative, facultatively anaerobic coccobacillus that was formerly designated CDC group dysgonic fermenter (DF)-3, occurring as a normal flora in human gut and rarely causing human infections such as bacteremia, abscess, diarrhea, and cholecystitis. In this study, we report a case of biliary sepsis caused by D. capnocytophagoides in a patient with biliary obstruction. A seventy four-year-old man, admitted to the hospital due to common bile-duct stone, also had cholangitis caused by D. capnocytophagoides and Enterococcus avium, which were isolated from his blood cultures. D. capnocytophagoides was initially identified as D. gadei by MALDI-TOF mass spectrometry, but later confirmed as D. capnocytophagoides by 16S rRNA gene sequencing. To the best of our knowledge, this is the first report of human infec-tion by D. capnocytophagoides in Korea.

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Microscopic findings and colony morphology of Dysgonomonas capnocytophagoides. (A) Gram-negative coccobacilli visualized under the microscope after 30.1 hr in the anaerobic culture vial (Gram stain, 1,000 ×). (B) Grey-white, smooth, and non-hemolytic colonies grew on blood agar, but none on MacConkey agar.

Biochemical test responses of the current isolate, compared to those of D. capnocytophagoides and Serratia plymuthica

    Response of
  
Biochemical test This case D. capnocytophagoides∗ Serratia plymuthica†,‡
Oxidase Negative Negative Negative
β-galactosidase Positive Positive Positive
Arginine dihydrolase Negative Negative Negative
Lysine decarboxylase Negative Negative Negative
Ornithine decarboxylase Negative Negative Negative
H2S production Negative Negative Negative
Urea hydrolysis Negative Negative Negative
Tryptophan deamination Negative Negative Negative
Indole production Negative Negative Negative
Acetoin production Positive Negative Positive
Gelatin hydrolysis Positive Negative Positive
Carbohydrate fermentation      
 Glucose Positive Positive Positive
 Mannitol Negative Negative Positive
 Inositol Negative Negative Negative
 Sorbitol Negative Negative Negative
 Rhamnose Negative Negative Negative
 Sucrose Positive Positive Positive
 Melibiose Positive Positive Positive
 Amygdalin Positive Positive Positive
 Arabinose Positive Positive Positive

CCUG 17996

(LMG 11519T) [1];

API 20E bioMerieux database (http://210.242.211.31/ jsp/ident/index.jsp API 20E V5.0);

Require differential diagnosis among API 20 E database.