Rothia mucilaginosa Sepsis in a Kidney Transplant Recipient Following Dental Procedure Despite Clindamycine Prophylaxis: A Case Report.

Rothia mucilaginosa is an opportunistic Gram-positive coccus that colonizes the oral cavity. However, in immunocompromised patients, it may cause severe invasive infections. We report a case of R. mucilaginosa sepsis in a kidney transplant recipient following a dental procedure despite prophylactic clindamycin therapy. A 64-year-old female kidney transplant recipient receiving maintenance immunosuppression with tacrolimus, mycophenolate mofetil, and prednisone underwent dental treatment because of profound dental caries with gingival inflammation. Clindamycin was administered because of history of adverse reactions to multiple antibiotics. However, within several days, the patient developed fever, chills, and progressive malaise. Blood cultures yielded R. mucilaginosa. The patient was successfully treated with intravenous piperacillin/tazobactam. Our case demonstrates the importance of recognizing uncommon oral pathogens in transplant recipients presenting with sepsis after dental procedures, as well as the limited antimicrobial activity of clindamycin against Rothia species.