| Summary: | <p>Abstract</p> <p>Background</p> <p><it>Helicobacter cinaedi </it>is a rare pathogen in humans, occurring mostly in immuno-compromised patients, with a high potential for recurrence. We describe a case of a patient with lymphoma hospitalized for chemotherapy.</p> <p>Case presentation</p> <p>At admission, the patient presented with an indolent and non-prurigenic macular rash around her implantable venous access device. Gram staining of blood cultures revealed the presence of spiral-shaped gram-negative rods that could not be grown upon subculture. <it>Helicobacter cinaedi </it>was identified by PCR. No other symptoms or pathology were observed in a whole body CT scan. The implantable venous access device was removed and empiric therapy by ceftriaxone and gentamicin for 2 weeks was initiated, followed by peroral clarithromycin 2 × 500 mg/day and later by levofloxacin 2 × 500 mg/day for 7 weeks. Oncologic remission was achieved 3 months later. However, the patient was re-hospitalized 2 months later for fever, shivering, reappearance of the macular non-prurigenic rash, diarrhea, cough and asthenia. Blood cultures grew <it>H. cinaedi</it>. Multiple investigations could not identify the source. Empiric antibiotic therapy of ceftriaxone and doxycycline was started for 2 weeks with resolution of symptoms, followed by an oral combination of amoxicillin, metronidazole and doxycycline for 2 months; doxycycline was continued for another month. Bacteremia has not recurred for a period of 19 months.</p> <p>Conclusion</p> <p>Although <it>H. cinaedi </it>is considered to be a low virulent bacteria, its potential to cause recurrent bacteremia should not be underestimated. <it>H. cinaedi </it>could have an endovascular source of infection and should be treated for an adequate duration with combined antibiotherapy.</p>
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