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Persistent bacteremia with Erysipelothrix rhusiopathiae in a hospitalized patient
M G Schuster1, P J Brennan, P Edelstein
1Department of Medicine, University of Pennsylvania School of Medicine, Philadelphia.
Abstract:
A patient with a history of alcohol abuse and pancreatitis presented with a pleural effusion resulting from a fistula between the pancreatic duct and left pleural space. Two weeks into her hospitalization, fever and persistent bloodstream infection with Erysipelothrix rhusiopathiae and Candida albicans developed. The patient had no history of exposure to animals. To our knowledge this is the first report of an E. rhusiopathiae infection presenting during hospitalization. This case suggests the possibility of a carrier state of infection and illustrates that a high index of suspicion is necessary for identification of unusual pathogens in hospitalized patients.
Insights
A rare bloodstream infection with Erysipelothrix rhusiopathiae and Candida albicans developed in a hospitalized patient with pancreatitis. This case highlights the need to consider unusual pathogens in critically ill patients.
Area of Science:
- Internal Medicine
- Infectious Diseases
- Gastroenterology
Background:
- Pancreatic fistulas can lead to serious complications, including infections.
- Erysipelothrix rhusiopathiae is an uncommon pathogen, typically associated with animal exposure.
Observation:
- A patient with alcohol abuse and pancreatitis developed a pancreaticopleural fistula.
- During hospitalization, the patient presented with fever and persistent bloodstream infections.
- The identified pathogens were Erysipelothrix rhusiopathiae and Candida albicans, despite no history of animal contact.
Findings:
- This is the first reported case of Erysipelothrix rhusiopathiae infection occurring during hospitalization.
- The patient's presentation suggests a potential carrier state for the infection.
- Co-infection with Candida albicans complicated the clinical picture.
Implications:
- Hospitalized patients, especially those with underlying conditions like pancreatitis, may harbor unusual pathogens.
- A high index of suspicion is crucial for diagnosing rare infections in hospitalized individuals.
- This case expands the understanding of Erysipelothrix rhusiopathiae epidemiology and clinical presentation.