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Enterococcus casseliflavus, Streptococcus equinus and Klebsiella oxytoca septicaemia associated with perinephric haematoma in a post-liver transplant patient with allograft cirrhosis
  1. Rajiv Prakash Heda1,
  2. Yolanda Savage2,
  3. Satheesh P Nair3 and
  4. Rajanshu Verma3
  1. 1 Medicine, UTHSC College of Medicine, Memphis, Tennessee, USA
  2. 2 Microbiology, Methodist University Hospital, Memphis, Tennessee, USA
  3. 3 Transplant Hepatology, Methodist University Hospital, UTHSC College of Medicine Memphis, Memphis, Tennessee, USA
  1. Correspondence to Dr Rajanshu Verma, rajanshu{at}


Liver transplant recipients are immunocompromised by the virtue of being on immunosuppressive agents which put them at risk of having infections from unusual and even multiple concomitant pathogens. We present a case of a 39-year-old man who developed septicaemia with Enterococcus casseliflavus, Streptococcus equinus and Klebsiella oxytoca in the setting of perinephric haematoma which resulted following a kidney biopsy performed to evaluate his nephrotic range proteinuria. E. casseliflavus has been known to cause infections in patients with liver disease/cirrhosis; however, simultaneous infection with S. equinus and K. oxytoca along with E. casseliflavus has never been reported earlier in post-transplant state.

  • malignant disease and immunosuppression
  • cirrhosis
  • gastroenterology
  • infectious diseases
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  • Contributors RV and SPN took care of the patient. YS worked on microbiology results of the patient cultures. RPH and RV drafted the initial version of the manuscript. All authors (RV, RPH, YS, SPN) contributed to the manuscript, made edits and approved the final version of manuscript for submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

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

  • Patient consent for publication Obtained.

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