Abstract
IntroductionEnterobacter cloacae is responsible for 65-75% of all Enterobacter infections, bacteremia being the most common syndrome. The majority of infections are nosocomially acquired and in patients with predisposing factors.Case presentationWe present a case of E. cloacae bacteremia secondary to acute cholecystitis in a 60-year-old man with recent diagnosis of cholelithiasis. The diagnosis was established with abdominal echography and positive blood and biliary cultures. The patient was managed successfully with cholecystectomy and antibiotic therapy.ConclusionThe peculiarity of our case is the development of community-acquired bacteremia due to E. cloacae with a clear infectious focus, as a single agent isolated in several blood cultures, in a patient without severe underlying diseases, prior antimicrobial use or previous hospital admission. Although the majority of Enterobacter spp. infections are nosocomially acquired, primary bacteremia being the most common syndrome, these pathogens may also be responsible for community-acquired cases. Patients without predisposing factors may also be affected.
Highlights
Introduction: Enterobacter cloacae is responsible for 65-75% of all Enterobacter infections, bacteremia being the most common syndrome
Case presentation: We present a case of E. cloacae bacteremia secondary to acute cholecystitis in a 60-year-old man with recent diagnosis of cholelithiasis
The peculiarity of our case is the development of community-acquired bacteremia due to E. cloacae with a clear infectious focus, as a single agent isolated in several blood cultures, in a patient without severe underlying diseases, prior antimicrobial use or previous hospital admission
Summary
Enterobacter spp. have been recognized as increasingly important pathogens in recent years, and have been implicated in a broad range of clinical syndromes, the majority of which are nosocomially acquired and in patients with predisposing factors [1]. Mild jaundice, abdominal tenderness in the right upper quadrant and a positive Murphy sign were noted. His blood pressure was 110/70 mmHg, his pulse was 130 beats per minute and his temperature was 39.5oC. All sets of the blood cultures grew E. cloacae, which was sensitive to empirical antibiotics. In imaging techniques, such as computed tomography and magnetic cholangioresonance, a collection was observed in the anterior subhepatic space, suggesting an abscess. The patient had a favorable outcome, leaving hospital 10 days later
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