• Giovanna Zavadzki, Tomás Reyes Barros, Alberto Sarfatis Feige, Jaime Granada Castaño, Valentina Kobus Garin, José Ramos-Rojas, Natália Bigossi Aguiar, and José Inzunza Robles.
• Fundación Epistemonikos, Universidad Federal de Sao Paulo, Brasil.
• Rev Med Chil. 2023 Jul 1; 151 (7): 941946941-946.

AbstractLawsonella clevelandensis is a gram-positive anaerobic bacillus, partially acid-fast, belonging to the order Corynebacteriales and is considered commensal of the skin and oral cavity. In recent years, few cases of infection by this microorganism have been reported, generally in immunosuppressed patients, with the most reported clinical presentation being the generation of abscesses. The isolation of this bacterium is difficult since it does not grow in traditional cultures, so its identification usually requires the use of molecular biology. We present the case of a 29-year-old patient with a kidney transplant and progressive worsening of kidney function in the context of a pauci-immune vasculitis which required greater immunosuppression. During the investigation, it was identified an asymptomatic leukocyturia, with a negative urine culture, for which six urine smear microscopy tests were performed of which 3 were positive, but with a negative Koch culture. Sequencing of the gene that codes for the 16s RNA of the bacterial ribosome was performed from a urine sample, obtaining a sequence compatible with Lawsonella clevelandensis. After the result, therapy with amoxicillin-clavulanic acid was indicated with resolution of the leukocyturia and negative smear microscopy, and immunosuppression could be indicated without inconvenience. To the authors' knowledge, this is the twelfth case of Lawsonella clevelandensis infection described in the medical literature in the world and the first to report the isolation of the pathogen in urine.

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