Leclercia adecarboxylata Bacteremia in a Patient with Ulcerative Colitis

Area of Science:

• Gastroenterology
• Infectious Diseases
• Microbiology

Background:

• Patients with inflammatory bowel disease (IBD) are at high risk for bacteremia.
• Disruptions in gastrointestinal mucosal architecture and endoscopic procedures contribute to this risk, especially in immunocompromised individuals.
• Opportunistic microorganisms are increasingly isolated from the bloodstream of IBD patients.

Purpose of the Study:

• To report a rare case of monomicrobial bacteremia caused by Leclercia adecarboxylata in a patient with inflammatory bowel disease.
• To discuss the potential contributing factors, including gut mucosal barrier derangement and endoscopic interventions, in the context of IBD.

Main Methods:

• Case report of a 43-year-old female presenting with bloody diarrhea.
• Diagnostic procedures included colonoscopy, histopathology, and blood cultures.
• Treatment involved intravenous antibiotics and subsequent IBD therapies.

Main Results:

• The patient was diagnosed with ulcerative colitis and enteropathic arthritis.
• Blood cultures identified monomicrobial Leclercia adecarboxylata bacteremia.
• Treatment with ceftriaxone, methylprednisolone, mesalamine, and infliximab led to symptom resolution.

Conclusions:

• Gut mucosal barrier derangement is a likely cause of bacteremia in IBD patients, even in immunocompetent individuals.
• Endoscopic interventions may play a role in bacterial translocation.
• Leclercia adecarboxylata, though rarely pathogenic, can cause significant bloodstream infections in susceptible patients.