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

BMJ Case Rep. 2017 May 12:2017:bcr2017219636. doi: 10.1136/bcr-2017-219636.

Abstract

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.

Keywords: Infection (gastroenterology); Infectious diseases; Pancreas and biliary tract.

Publication types

  • Case Reports

MeSH terms

  • Aged
  • Ampicillin / administration & dosage
  • Ampicillin / therapeutic use*
  • Bacteremia / complications
  • Bacteremia / diagnosis*
  • Bacteremia / drug therapy
  • Clostridioides difficile / isolation & purification*
  • Diagnosis, Differential
  • Enterococcus faecalis / isolation & purification*
  • Gram-Positive Bacterial Infections / complications
  • Gram-Positive Bacterial Infections / diagnosis*
  • Gram-Positive Bacterial Infections / drug therapy
  • Hepatitis A / complications
  • Hepatitis A / diagnosis*
  • Hepatitis A / drug therapy
  • Humans
  • Infusions, Intravenous
  • Male
  • Vancomycin / administration & dosage
  • Vancomycin / therapeutic use*
  • beta-Lactams / administration & dosage

Substances

  • beta-Lactams
  • Vancomycin
  • Ampicillin