Ascending cholangitis presenting with Lactococcus lactis cremoris bacteraemia: a case report.

Area of Science:

• Medical Microbiology
• Infectious Diseases

Background:

• Lactococcus lactis cremoris is a Gram-positive bacterium not usually considered pathogenic in healthy individuals.
• Invasive infections by this organism are rare, with only 12 previous reports.
• This is the first documented case of cholangitis caused by Lactococcus lactis cremoris.

Purpose of the Study:

• To report a rare case of cholangitis caused by Lactococcus lactis cremoris.
• To highlight the potential pathogenicity of this organism in immunocompetent adults.
• To contribute to the understanding of empirical antibiotic therapy for such infections.

Main Methods:

• A case study of a 72-year-old patient presenting with symptoms of cholangitis.
• Diagnosis confirmed by identifying Lactococcus lactis cremoris bacteremia.
• Treatment involved biliary drainage via endoscopic retrograde cholangiography and broad-spectrum antibiotics.

Main Results:

• The patient presented with Charcot's triad, indicative of cholangitis.
• Lactococcus lactis cremoris was identified as the causative agent of bacteremia and cholangitis.
• Successful management required both endoscopic intervention and multi-agent antibiotic therapy.

Conclusions:

• This case supports evidence that Lactococcus lactis cremoris can act as a pathogen in immunocompetent adults.
• The optimal empirical antibiotic treatment for Lactococcus lactis cremoris cholangitis remains under discussion.
• Clinicians should maintain a broad differential diagnosis to include less common pathogens in severe infections.