BMJ Case Reports 2017; doi:10.1136/bcr-2017-219636
  • Rare disease

Enterococcus casseliflavus septicaemia associated with hepatobiliary infection in a 75-year-old man

  1. Allison L Baroco
  1. 1Department of Hospital Medicine, Augusta Health, Fishersville, Virginia, USA
  2. 2Hospital Medicine, United Hospital, Allina Health, St Paul, Minnesota, USA
  1. Correspondence to Dr Rajanshu Verma, rajanshu{at}
  • Accepted 27 April 2017
  • Published 12 May 2017


Enterococcus casseliflavus is a rare non-faecium, non-faecalis, vancomycin-resistant enterococcus (VRE) that is responsible for up to 2% of all enterococcal infections. Septicaemia with this bacterium is usually seen in older patients with multiple comorbidities who have had several previous hospitalisations. Septicaemia with E. casseliflavus portends a poorer prognosis, and treatment usually involves administration of antienterococcal beta-lactams or anti-VRE medications such as linezolid or daptomycin. We present such a case of a 75-year-old man who developed E. casseliflavus septicaemia of presumably hepatobiliary origin and responded well to treatment with intravenous beta-lactams.


  • Contributors Both RV and ALB took care of the patient. Both RV and ALB contributed to the manuscript, edited and approved the final draft.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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