Abstract
BackgroundInfections caused by Enterococcus hirae are common in animals, with instances of transmission to humans being rare. Further, few cases have been reported in humans because of the difficulty in identifying the bacteria. Herein, we report a case of pyelonephritis caused by E. hirae bacteremia and conduct a literature review on E. hirae bacteremia.Case presentationA 57-year-old male patient with alcoholic cirrhosis and neurogenic bladder presented with fever and chills that had persisted for 3 days. Physical examination revealed tenderness of the right costovertebral angle. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) of the patient’s blood and urine samples revealed the presence of E. hirae, and pyelonephritis was diagnosed. The patient was treated successfully with intravenous ampicillin followed by oral linezolid for a total of three weeks.ConclusionThe literature review we conducted revealed that E. hirae bacteremia is frequently reported in urinary tract infections, biliary tract infections, and infective endocarditis and is more likely to occur in patients with diabetes, liver cirrhosis, and chronic kidney disease. However, mortality is not common because of the high antimicrobial susceptibility of E. hirae. With the advancements in MALDI-TOF MS, the number of reports of E. hirae infections has also increased, and clinicians need to consider E. hirae as a possible causative pathogen of urinary tract infections in patients with known risk factors.
Highlights
Infections caused by Enterococcus hirae are common in animals, with instances of transmission to humans being rare
The literature review we conducted revealed that E. hirae bacteremia is frequently reported in urinary tract infections, biliary tract infections, and infective endocarditis and is more likely to occur in patients with diabetes, liver cirrhosis, and chronic kidney disease
Pyelonephritis [3–5], infective endocarditis [6–11], and biliary tract infections [5, 12] due to E. hirae have been reported in human patients
Summary
Infections caused by Enterococcus hirae are common in animals, with instances of transmission to humans being rare. We report a case of pyelonephritis caused by E. hirae bacteremia and conduct a literature review on E. hirae bacteremia. Matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) of the patient’s blood and urine samples revealed the presence of E. hirae, and pyelonephritis was diagnosed. Enterococcus hirae primarily causes zoonosis [1, 2], with human infections being relatively rare. Pyelonephritis [3–5], infective endocarditis [6–11], and biliary tract infections [5, 12] due to E. hirae have been reported in human patients. In a case of urinary tract infection, E. hirae was rapidly and correctly identified using MALDI-TOF MS, without any complementary tests [14]. We report a case of bacteremia secondary to pyelonephritis caused by E. hirae identified by MALDI-TOF MS, which was successfully treated with ampicillin followed by linezolid. We conducted a literature review on bacteremia caused by E. hirae
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