Enterococcus hirae Bacteremia Associated With Traumatic Soft Tissue Infection: A Case Report

In recent years, reports of Enterococcus hirae infections in humans have increased. Similarly to most known Enterococci, E. hirae has been identified mostly in bacteremia, urinary tract infections, infective endocarditis, and biliary tract infections. We present a case of E. hirae bacteriemia associated with traumatic soft tissue infection in a 77-year-old male patient, a polytrauma victim with a tibia-fibula open fracture after a forklift accident. Initially, the patient underwent a left below-the-knee amputation but it evolved poorly, with necrosis of the surgical stump. Debridement and antibiotics were started. Blood and soft tissue cultures identified E. hirae. An above-the-knee amputation was necessary, and the patient improved satisfactorily. Our case study helps to confirm the unexpected E. hirae in humans as well as report an unusual source of infection of this pathogen. Further studies and more case reports are needed to elucidate the clinical impact of Enterococcus hirae on humans.