Abstract
BackgroundThe Leuconostoc mesenteroides are members of the Streptococcae family and currently has been recognized as potential pathogens. This case describes a bacteremia caused by L. mesenteroides in an immunocompetent patient affected by Chagas disease.Case presentationA 67-year-old female patient with chagasic megaesophagus and megacolon was submitted to a Heller myotomy for achalasia in 2000 and endoscopic dilatation in 2015. Patient was admitted to the Nutrology Ward in May 2016 with protein-calorie malnutrition associated with achalasia and receiving enteral nutrition. In July 2016, the patient underwent a Serra-Doria surgery. In the third postoperative day she presented an important abdominal distension. She was submitted to a new surgical intervention, and then a terminal ileum perforation was detected, leading the surgeon to perform an enterectomy with side-to-side anastomosis. The next day after the surgery (4th postoperative day) the patient presented a decreased level of consciousness (Glasgow coma scale = 8), hypotension and hypoxemia. In two samples of blood cultures there was growth of Leuconostoc mesenteroides. Susceptibility pattern was evaluated by the diffusion disk method. The microorganism was susceptible to penicillin, ampicillin, chloramphenicol, erythromycin, and fluoroquinolones, but resistant to rifampin, tetracycline, vancomycin and teicoplanin.ConclusionWe concluded that infections caused by L. mesenteroides is serious and should be considered not only in settings of immunosuppression and prolonged antimicrobial use, but also in immunocompetent patients undergoing surgeries involving the gastrointestinal tract.
Highlights
The Leuconostoc mesenteroides are members of the Streptococcae family and currently has been recognized as potential pathogens
We concluded that infections caused by L. mesenteroides is serious and should be considered in settings of immunosuppression and prolonged antimicrobial use, and in immunocompetent patients undergoing surgeries involving the gastrointestinal tract
In a retrospective study conducted in a tertiary-care hospital six cases of bacteremia due to Leuconostoc spp. in children with short bowel syndrome were analyzed, all of them using total parenteral nutrition [6]
Summary
We concluded that infections caused by L. mesenteroides is serious and should be considered in settings of immunosuppression and prolonged antimicrobial use, and in immunocompetent patients undergoing surgeries involving the gastrointestinal tract. Abbreviations APACHE II: Acute Physiology and Chronic Health Evaluation II; ICU: Intensive Care Unit
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