First case report of acute cholangitis secondary to Cronobacter sakazakii

BMC Infect Dis. 2021 May 27;21(1):493. doi: 10.1186/s12879-021-06195-4.

Abstract

Introduction: Cronobacter sakazakii is an opportunistic Gram-negative, rod-shaped bacterium which may be a causative agent of meningitis in premature infants and enterocolitis and bacteremia in neonates and adults. While there have been multiple cases of C. sakazakii infections, there have been no acute cholangitis cases reported in humans.

Case presentation: An 81-year-old male with a past medical history of basal cell carcinoma, alcoholic liver cirrhosis, transjugular intrahepatic portosystemic shunt procedure, complicated by staphylococcus bacteremia, pituitary tumor, glaucoma, and hypothyroidism presented to the emergency room with the complaint of diffuse and generalized 10/10 abdominal pain of 1 day's duration. There was a concern for pancreatitis, acute cholangitis, and possible cholecystitis, and the patient underwent a percutaneous cholecystostomy tube placement. Blood cultures from admission and biliary fluid cultures both grew C. sakazakii. The patient was treated with a carbapenem and clinically improved.

Conclusions: The case study described a patient with multiple medical comorbidities that presented with C. sakazakii bacteremia and cholangitis. While this bacterium has been implicated in other infections, we believe this is the first time the bacteria is being documented to have caused acute cholangitis.

Keywords: Cholangitis; Cholecystitis; Cronobacter sakazakii; Gallbladder infection.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / complications
  • Bacteremia / diagnosis*
  • Bacteremia / therapy
  • Carbapenems / therapeutic use
  • Cholangitis / diagnosis*
  • Cholangitis / microbiology
  • Cholangitis / therapy
  • Cholecystostomy / methods
  • Cronobacter sakazakii / isolation & purification*
  • Cronobacter sakazakii / pathogenicity
  • Drainage / methods
  • Enterobacteriaceae Infections / complications
  • Enterobacteriaceae Infections / diagnosis*
  • Enterobacteriaceae Infections / therapy
  • Humans
  • Male
  • Opportunistic Infections / diagnosis
  • Opportunistic Infections / microbiology
  • Opportunistic Infections / therapy
  • Polymerase Chain Reaction / methods
  • Tomography, X-Ray Computed / methods
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Carbapenems