Staphylococcus saccharolyticus bacteremia presenting with fever and headache

Staphylococcus saccharolyticus is a slow-growing anaerobic coagulase-negative staphylococcus and a rare cause of bloodstream infections. We report the case of a previously healthy 35-year-old woman who presented with fever and headache. One anaerobic bottle from each of two separately collected blood culture sets became positive after 53 h, and S. saccharolyticus was identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry; both aerobic bottles remained negative. No focus of infection was detected. Repeat cultures drawn on day 3, before vancomycin treatment was started, were already negative. The patient received ceftriaxone for 3 days, vancomycin for 4 days, and oral clindamycin for 8 days, and recovered without relapse. The minimum inhibitory concentrations were obtained using a panel developed for aerobically growing gram-positive cocci and were reported without categorical interpretation, as no breakpoints have been validated for this species. Detection in two separately collected sets may represent true bacteremia even in the absence of an implanted device or comorbidity.