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Helicobacter fennelliae  is an enterohepatic  Helicobacter  species causing bacteraemia in immunocompromised hosts. Only a few cases of recurrent  H. fennelliae  bacteraemia have been reported in Japan and there are no guidelines regarding antimicrobial treatment for  H. fennelliae  infection.    Case presentation:   H. fennelliae  bacteraemia was observed in a patient receiving platinum-based chemotherapy for lung cancer. To prevent recurrence, the patient received antibiotic therapy with cefepime, amoxicillin and doxycycline for 6 weeks, which is similar to the therapy for  Helicobacter   cinaedi  bacteraemia. Bacteraemia recurred despite the long-term antibiotic therapy. We hypothesized that the  H. fennelliae  bacteraemia originated from endogenous infection in the intestinal tract due to the long-term damage of the enteric mucosa by platinum-based drugs and performed selective digestive decontamination (SDD) with kanamycin. Bacteraemia did not recur after SDD.    Conclusion:  Our observations indicate that clinicians should be aware of possible recurrent  H. fennelliae  bacteraemia, which could be effectively prevented by SDD with kanamycin.

jmm case reports

Successful treatment of recurrent Helicobacter fennelliae bacteraemia by selective digestive decontamination with kanamycin in a lung cancer patient receiving chemotherapy