Eggerthella lenta bacteraemia in a patient with Caroli disease

Abstract

Introduction: Eggerthella lenta is an obligate anaerobic, non-spore-forming, Gram-positive rod found as a normal commensal of the human intestinal flora, which is capable of reducing digoxin into several metabolites. Disease caused by this micro-organism is unusual, although more frequent than reported. Case presentation: A 74-year-old man presented to the emergency room and was admitted with a mild acute cholangitis syndrome. One anaerobic blood culture became positive after 5 days of incubation. After an additional 5 days, the usual aerobic subcultures were negative, whereas anaerobically incubated Columbia blood agar presented tiny smooth colonies. The isolate was capable of reducing digoxin and was identified as Eggerthella lenta. Adequate antibiotic treatment with meropenem had been started and the patient recovered fully. Conclusion: We have described a patient with a potentially fatal bacteraemia with E. lenta that may have gone unnoticed. More case reports are necessary, not only to understand the pathogenicity and clinical course of infections by this neglected bacterium, but also to investigate its digoxin degradation and antimicrobial susceptibility variability.