Elizabethkingia miricola Causes Intracranial Infection: A Case Study.

Hongguang Gao,Tian Li,Li Feng,Shu Zhang

doi:10.3389/fmed.2021.761924

Abstract

Background: Elizabethkingia miricola is a rarely encountered bacterium in clinical practice. It is a rare gram-negative rod-shaped bacterium associated with lung and urinary tract infections, but never found in cerebrospinal fluid. This paper reports a case of an adult patient infected by E. miricola via an unknown route of infection causing a severe intracranial infection. Elizabethkingia miricola was detected by culture and Metagenomic next generation sequencing in CSF. Early identification of this strain and treatment with sensitive antibiotics is necessary to reduce morbidity and mortality.Case Report: A 24-year-old male was admitted to a West China Hospital because of headache and vomiting for 2 months. Symptom features included acute onset and long duration of illness. Notably, headache and vomiting were the primary neurological symptoms. Routine cerebrospinal fluid culture failed to identify the bacterium; however, Elizabethkingia miricola bacterium was detected via second-generation sequencing techniques. Elizabethkingia miricola was found to be a multi-drug resistant organism, hence, treatment with ceftriaxone, a commonly used drug for intracranial infections was ineffective. This strain eventually caused severe intracranial infection resulting in the death of the patient.Conclusion: In summary, this study comprehensively describes a case of an adult patient infected by E. miricola and discusses its early identification as well as application of sensitive antibiotics in the emergency setting.

Highlights

Elizabethkingia miricola is an aerobic, non-budding, non-fermenting, non-motile, elongated, and slightly curved Gram-negative bacillus that causes bacteremia in humans [1]
The cerebrospinal fluid culture specimen was subjected to PCR and mass spectrometry analysis, where it was identified as Elizabethkingia miricola (Figure 3)
According to the clinical symptoms and signs, combined with the results of cerebrospinal fluid culture, the patient was diagnosed as bacterial meningoencephalitis [7]

Summary

Background

Elizabethkingia miricola is a rarely encountered bacterium in clinical practice. It is a rare gram-negative rod-shaped bacterium associated with lung and urinary tract infections, but never found in cerebrospinal fluid. Elizabethkingia miricola was detected by culture and Metagenomic generation sequencing in CSF. Identification of this strain and treatment with sensitive antibiotics is necessary to reduce morbidity and mortality. Routine cerebrospinal fluid culture failed to identify the bacterium; Elizabethkingia miricola bacterium was detected via second-generation sequencing techniques. Elizabethkingia miricola was found to be a multi-drug resistant organism, treatment with ceftriaxone, a commonly used drug for intracranial infections was ineffective. This strain eventually caused severe intracranial infection resulting in the death of the patient

Conclusion

INTRODUCTION

Sensitivity Methods Breakpoints

28 Resistance KB

ETHICS STATEMENT