Bactibilia due to enterococcus species in a case of periampullary carcinoma

Biliary obstruction due to pancreaticobiliary malignancy is often accompanied by bactibilia and cholangitis; which are associated with postoperative septic complications and may adversely affect the clinical course. The enterococcus species is most responsible for postoperative complications in patients with malignant biliary obstruction. Here a case of bactibilia in a 60-year-old male patient, admitted with peri-ampullary carcinoma is reported. The bile sent for Gram-stain showed the presence of pus cells and Gram-positive cocci in pairs and the bacteriological culture revealed the growth of Enterococcus faecium. The patient developed fever with chills on the second postoperative day. The blood cultures of the patient showed growth of Enterococcus faecium for which he was given vancomycin. The patient went on to develop a surgical site infection, the wound swab of which revealed the growth of klebsiella species. The patient was treated for the wound infection and was later on discharged after three weeks of hospital stay. The patient was doing well during follow-up with the subsidence of the jaundice and Iiver enzymes.