Photo Quiz: Gram-Variable Staining in Anaerobic Bacteremia.

Abstract

A 62-year-old male patient was admitted to the surgical intensive care unit (ICU) for secondary peritonitis and septic shock. His medical history included laryngeal cancer, adrenal insufficiency, and a recent total colectomy for acute mesenteric ischemia. An urgent exploratory laparotomy revealed an anastomotic leak secondary to the colectomy. Anastomotic takedown and peritoneal lavage were performed, with a Gram stain of the peritoneal fluid showing a polymicrobial flora. Antimicrobial therapy with piperacillin-tazobactam, amikacin, and caspofungin was initiated.