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Pancreatic abscess secondary to Alcaligenes faecalis

Mahi Lakshmi Ashwath1, Harold P Katner

  • 1Department of Internal Medicine, Mercer University School of Medicine, Macon, Georgia, USA. Mahi_Lakshmi@yahoo.com

The American Journal of the Medical Sciences
|January 18, 2005
PubMed

Insights

A rare Alcaligenes faecalis infection led to pancreatic abscesses and necrosis in a patient with acute pancreatitis. Early surgical drainage is crucial to prevent the selection of resistant pathogens like A. faecalis.

Area of Science:

  • Infectious Diseases
  • Gastroenterology
  • Surgical Pathology

Background:

  • Alcohol-induced acute pancreatitis can lead to severe complications.
  • Pancreatic necrosis and abscess formation are serious sequelae requiring prompt management.

Observation:

  • A patient with alcohol-induced acute pancreatitis developed secondary pancreatic necrosis and abscesses.
  • The abscess fluid culture revealed Alcaligenes faecalis, a pathogen resistant to meropenem.
  • Initial treatment with meropenem and delayed surgical drainage contributed to persistent fever and pathogen resistance.

Findings:

  • Alcaligenes faecalis can cause pancreatic abscesses, particularly in cases with delayed surgical intervention.
  • Meropenem resistance in A. faecalis was observed, necessitating alternative treatment strategies.
  • Successful recovery was achieved only after surgical intervention and appropriate antibiotic therapy.

Implications:

  • This case highlights the critical importance of early surgical drainage for pancreatic abscesses.
  • Delayed intervention can promote the selection of multidrug-resistant organisms.
  • Clinicians should consider early surgical consultation and intervention in managing complex pancreatic infections.

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