Vol.74 No.2 March 2026

A case of overlap syndrome with septic embolism caused by Gordonia hongkongensis

Yusuke Oka¹⁾, Takashi Matono¹⁾, Toshiharu Urakami¹⁾, Tsubasa Maeda²⁾, Mariko Sakai²⁾, Yukiko Takeyama²⁾, Megumi Oho³⁾, Yoshifumi Tada²⁾ and Yosuke Aoki^{1, 4)}

¹⁾Division of Infectious Disease and Hospital Epidemiology, Saga University Hospital, 5-1-1 Nabeshima, Saga City, Saga, Japan
²⁾Department of Rheumatology and Collagen Diseases, Saga University Hospital
³⁾Department of Laboratory Medicine, Saga University Hospital
⁴⁾Nayutanomori Hospital

Abstract

Gordonia species are environmental, gram-positive, rod-shaped bacteria that have been recognized as rare causative pathogens of catheter-related bloodstream infection. We report the case of a patient with systemic scleroderma-systemic lupus erythematosus overlap syndrome who was diagnosed as having bacteremia and pulmonary septic embolism caused by Gordonia hongkongensis. The patient was a 46-year-old woman who was receiving long-term parenteral central venous nutrition at home because of impaired gastrointestinal peristalsis associated with systemic scleroderma via a peripherally inserted central catheter (PICC), which had been in place for three years. She was admitted with an acute-onset fever, and two sets of blood cultures revealed gram-positive rods. Species identification using MALDI-TOF MS and 16S rRNA gene sequencing confirmed the isolate as G. hongkongensis. Despite removal of the PICC and initiation of antimicrobial therapy, initially with meropenem, later switched to ceftriaxone, the patient died on the 18th day of hospitalization. Gram staining could lead to Gordonia spp. being misidentified as Nocardia spp. or Corynebacterium spp., and conventional biochemical methods often fail to accurately distinguish between these organisms. Accurate identification is critical for predicting the antimicrobial susceptibility and guiding appropriate initial therapy, so that it is important to develop rapid and precise molecular diagnostic techniques for identification of this species. This case underscores the importance of diagnostic stewardship in optimizing antimicrobial agent therapy.

Key word

Gordonia hongkongensis, systemic lupus erythematosus, bacteremia, septic embolism

Received

July 15, 2025

Accepted

October 30, 2025

Jpn. J. Chemother. 74 (2): 179-186, 2026