Sepsis secondary to multifocal Enterococcus faecium infection: A case report

Area of Science:

• Infectious Diseases
• Critical Care Medicine
• Microbiology

Background:

• Nosocomial Enterococcus faecium infections are prevalent in immunocompromised patients.
• Sepsis due to E. faecium is an uncommon but severe clinical presentation.

Observation:

• A 69-year-old female with a history of tuberculosis (TB) presented with prolonged respiratory symptoms.
• Initial misdiagnosis as recurrent TB and lack of response to anti-TB therapy.
• Multifocal E. faecium infection confirmed via blood, tissue, and urine cultures.

Findings:

• The patient received combination antimicrobial therapy including linezolid, teicoplanin, caspofungin, and voriconazole.
• Despite initial improvement, the patient experienced secondary infections and ultimately died after leaving against medical advice.

Implications:

• E. faecium bacteremia can precipitate sepsis with a significant mortality risk in immunocompromised hosts.
• Emphasizes the importance of thorough pathogen detection and timely, targeted antimicrobial interventions.
• Highlights the challenges in managing complex, multifocal infections in vulnerable patient populations.