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A Rare Presentation of Cholangitis Associated With Invasive Streptococcus Pyogenes
Dominique M Ebedes1, Jennifer Caputo-Seidler1
1Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, USA.
This case report details a rare instance of Streptococcus pyogenes causing cholangitis in a patient with advanced pancreatic cancer. The infection presented with severe symptoms, highlighting the bacterium
Area of Science:
- Infectious Diseases
- Gastroenterology
- Oncology
Background:
- Streptococcus pyogenes (S. pyogenes) commonly causes skin and throat infections.
- Invasive S. pyogenes infections are rare but can be severe.
- Metastatic pancreatic adenocarcinoma presents significant challenges in patient management.
Observation:
- A 34-year-old man with metastatic pancreatic cancer developed cholangitis.
- Symptoms included fever, jaundice, abdominal pain, altered mental status, and hypotension.
- Percutaneous transhepatic cholangiogram revealed biliary duct obstruction.
Findings:
- Blood and biliary fluid cultures confirmed S. pyogenes infection.
- Biliary fluid also showed Lactobacillus and Saccharomyces.
- The patient was treated with ampicillin-sulbactam and fluconazole.
Implications:
- This case underscores the potential for S. pyogenes to cause invasive biliary infections.
- Early recognition and treatment are crucial for managing such rare complications.
- Co-infections with other microorganisms can occur in immunocompromised patients.
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