Cefoperazone-sulbactam and ornidazole for Gardnerella vaginalis bloodstream infection after cesarean section: A case report

BACKGROUND: Gardnerella vaginalis (G. vaginalis) is a facultative anaerobic bacteria known to cause bloodstream infections. However, cases are very rare in clinics. There is very limited clinical experience in the treatment of bloodstream infections caused by G. vaginalis. Therefore, there is an urgent need for effective antibacterial drugs to treat patients with bloodstream infections caused by G. vaginalis. CASE SUMMARY: A woman who underwent a cesarean section presented with a sudden onset of high fever 1-d post-surgery. The blood cultures suggested an infection due to G. vaginalis, and treatment with cefoperazone-sulbactam was started. After 5 d of treatment, there was a decrease in the hemogram; however, the temperature and C-reactive protein levels remained high. Based on clinical experience and a review of literature, the treatment was modified to include ornidazole in combination with cefoperazone-sulbactam. Following a week of treatment, the temperature, hemogram and C-reactive protein levels returned to normal, and blood cultures turned negative, suggesting a therapeutic effect of the combination treatment. CONCLUSION: This case highlighted the effective use of cefoperazone-sulbactam combined with ornidazole for bloodstream infection caused by G. vaginalis following a cesarean section.