Elizabethkingia anophelis infection in an infant: an unusual presentation

A 7-month-old male infant presented with history of fever for 2 weeks, multiple ecchymotic patches over face, trunk and lower limbs, and one episode of seizure. The infant had shock, respiratory failure, severe anaemia, thrombocytopenia and temporoparietal haematoma on CT scan of the head. He was managed with supportive care and broad-spectrum empiric antibiotics. Two consecutive blood cultures grew Elizabethkingia anophelis, sensitive only to piperacillin-tazobactam. The infant responded to therapy and was discharged after 2 weeks of hospital stay. Repeated coagulation studies done to rule out an underlying bleeding disorder were negative. There was no clue in favour of non-accidental trauma. We report this case to highlight the unusual clinical presentation of this emerging pathogen. Mostly reported in outbreaks from surgical and post-operative intensive care units, it was worrisome to find this infant presenting with community-acquired E. anophelis infection.