Open AccessSepsis secondary to multifocal Enterococcus faecium infection
Author(s) -
Xiaoqing Huang,
Junke Qiu,
Caihong Wang,
Lei Pan,
Jiaming Xu,
Xiaohong Pan,
Xiao-bo Ji,
Minjie Mao
Publication year - 2020
Publication title -
medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.59
H-Index - 148
eISSN - 1536-5964
pISSN - 0025-7974
DOI - 10.1097/md.0000000000019811
Subject(s) - medicine , linezolid , teicoplanin , enterococcus faecium , bacteremia , caspofungin , sepsis , voriconazole , intensive care medicine , vancomycin , surgery , antibiotics , dermatology , antifungal , microbiology and biotechnology , biology , bacteria , genetics , staphylococcus aureus
Nosocomial Enterococcus faecium ( E faecium ) infections are common among immunocompromised patients; however, sepsis caused by E faecium is rarely encountered in the clinical setting. Patient concerns: A 69-year-old woman with a previous history of tuberculosis (TB), developed symptoms of recurrent fever, paroxysmal cough, and exertional dyspnea for over 2 months before she presented to the hospital. Diagnosis: The patient was initially misdiagnosed with recurrent TB, and did not respond to anti-TB therapy. Culture results of blood, endotracheal necrotic tissue, and urine confirmed a diagnosis of multifocal E faecium infection. Interventions: On definitive diagnosis, the patient received intensive antimicrobial combination treatment with linezolid, teicoplanin, caspofungin, and voriconazole on the basis of antimicrobial susceptibility results. Outcomes: After transient improvement, the patient's condition deteriorated due to secondary infections, and the patient died after discharge against medical advice. Conclusion: E faecium bacteremia may cause sepsis in immunocompromised patients, and has a high mortality rate. Careful pathogen detection and early initiation of treatment is crucial to good patient outcome.