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Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient

Patient: Female, 74-year-old Final Diagnosis: Leclercia adecarboxylata bacteremia Symptoms: Cough • fever • shock • shortness of breath Medication: — Clinical Procedure: — Specialty: Infectious Diseases • Microbiology and Virology OBJECTIVE: Rare disease BACKGROUND: Leclercia adecarboxylata is a gra...

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Autores principales: Shaikhain, Talal, Al-Husayni, Faisal, Al-Fawaz, Sarah, Alghamdi, Erada M., Al-Amri, Abdulfattah, Alfares, Mona
Formato: Online Artículo Texto
Lenguaje:English
Publicado: International Scientific Literature, Inc. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019838/
https://www.ncbi.nlm.nih.gov/pubmed/33782375
http://dx.doi.org/10.12659/AJCR.929537
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author Shaikhain, Talal
Al-Husayni, Faisal
Al-Fawaz, Sarah
Alghamdi, Erada M.
Al-Amri, Abdulfattah
Alfares, Mona
author_facet Shaikhain, Talal
Al-Husayni, Faisal
Al-Fawaz, Sarah
Alghamdi, Erada M.
Al-Amri, Abdulfattah
Alfares, Mona
author_sort Shaikhain, Talal
collection PubMed
description Patient: Female, 74-year-old Final Diagnosis: Leclercia adecarboxylata bacteremia Symptoms: Cough • fever • shock • shortness of breath Medication: — Clinical Procedure: — Specialty: Infectious Diseases • Microbiology and Virology OBJECTIVE: Rare disease BACKGROUND: Leclercia adecarboxylata is a gram-negative rod, which is normally found in water and food. It is an emerging pathogen that affects immunocompromised patients, including patients with hematological malignancies or those receiving chemotherapy. Generally, L. adecarboxylata is considered a low-virulence pathogen with an excellent susceptibility profile, but some strains may be resistant to multiple antibiotics, such as β-lactams. Moreover, L. adecarboxylata is usually isolated as a part of polymicrobial cultures in immunocompetent individuals, but there have been cases where it was the only isolate. CASE REPORT: A 74-year-old woman who was non-immunosuppressed and had multiple comorbidities was admitted with acute decompensated heart failure due to pneumonia. She was treated with multiple courses of antibiotics including amoxicillin-clavulanate and ciprofloxacin for pneumonia, but her infection worsened, and she had cardiopulmonary arrest. After resuscitation, she was stable for several days but suddenly became confused and hypotensive. The septic screen showed L. adecarboxylata bacteremia without a clear source, which was treated successfully with meropenem for 14 days. After the meropenem course, the patient developed diarrhea and was found to have severe Clostridium difficile infection. She did not respond to oral vancomycin and intravenous metronidazole and died. CONCLUSIONS: This case illustrated an infection in a non-immunosuppressed individual by an organism that is considered an opportunistic pathogen, mainly affecting immunocompromised patients. The patient’s blood culture grew L. adecarboxylata, which was sensitive to all antibiotics but resolved with meropenem treatment. Owing to increasing L. adecarboxylata infections, we recommend further studies to understand the organism’s pathogenesis, risk factors, and resistance pattern.
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spelling pubmed-80198382021-04-06 Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient Shaikhain, Talal Al-Husayni, Faisal Al-Fawaz, Sarah Alghamdi, Erada M. Al-Amri, Abdulfattah Alfares, Mona Am J Case Rep Articles Patient: Female, 74-year-old Final Diagnosis: Leclercia adecarboxylata bacteremia Symptoms: Cough • fever • shock • shortness of breath Medication: — Clinical Procedure: — Specialty: Infectious Diseases • Microbiology and Virology OBJECTIVE: Rare disease BACKGROUND: Leclercia adecarboxylata is a gram-negative rod, which is normally found in water and food. It is an emerging pathogen that affects immunocompromised patients, including patients with hematological malignancies or those receiving chemotherapy. Generally, L. adecarboxylata is considered a low-virulence pathogen with an excellent susceptibility profile, but some strains may be resistant to multiple antibiotics, such as β-lactams. Moreover, L. adecarboxylata is usually isolated as a part of polymicrobial cultures in immunocompetent individuals, but there have been cases where it was the only isolate. CASE REPORT: A 74-year-old woman who was non-immunosuppressed and had multiple comorbidities was admitted with acute decompensated heart failure due to pneumonia. She was treated with multiple courses of antibiotics including amoxicillin-clavulanate and ciprofloxacin for pneumonia, but her infection worsened, and she had cardiopulmonary arrest. After resuscitation, she was stable for several days but suddenly became confused and hypotensive. The septic screen showed L. adecarboxylata bacteremia without a clear source, which was treated successfully with meropenem for 14 days. After the meropenem course, the patient developed diarrhea and was found to have severe Clostridium difficile infection. She did not respond to oral vancomycin and intravenous metronidazole and died. CONCLUSIONS: This case illustrated an infection in a non-immunosuppressed individual by an organism that is considered an opportunistic pathogen, mainly affecting immunocompromised patients. The patient’s blood culture grew L. adecarboxylata, which was sensitive to all antibiotics but resolved with meropenem treatment. Owing to increasing L. adecarboxylata infections, we recommend further studies to understand the organism’s pathogenesis, risk factors, and resistance pattern. International Scientific Literature, Inc. 2021-03-30 /pmc/articles/PMC8019838/ /pubmed/33782375 http://dx.doi.org/10.12659/AJCR.929537 Text en © Am J Case Rep, 2021 This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Articles
Shaikhain, Talal
Al-Husayni, Faisal
Al-Fawaz, Sarah
Alghamdi, Erada M.
Al-Amri, Abdulfattah
Alfares, Mona
Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient
title Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient
title_full Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient
title_fullStr Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient
title_full_unstemmed Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient
title_short Leclercia adecarboxylata Bacteremia without a Focus in a Non-Immunosuppressed Patient
title_sort leclercia adecarboxylata bacteremia without a focus in a non-immunosuppressed patient
topic Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019838/
https://www.ncbi.nlm.nih.gov/pubmed/33782375
http://dx.doi.org/10.12659/AJCR.929537
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