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( Zoraida Dwi Wahyuni ),( Gatoet Ismanoe ) 대한내과학회 2014 대한내과학회 추계학술발표논문집 Vol.2014 No.1
Introduction: Elizabethkingia meningoseptica, previously known as Chryseobacterium meningosepticum, is a non-fermenting, oxidase-positive, non-motile, Gram-negative aerobic bacillus, has been reported as a cause of neonatal and adult meningitis, bacteraemia/ sepsis, pneumonia, nosocomial outbreaks, and other infection, especially in immunocompromised hosts. This organism is resistant to many antimicrobial agents, frequently used to target Gram-negative bacterial infections. Case: A 65-year-old male, medical doctor, with background diabetes mellitus and hypertension presented with fever since 7 days before admission, accompanied with productive cough. Initial history, physical examination and laboratory tests were consistent with the diagnosis of systemic infi ammatory response syndrome and severe acute respiratory distress syndrome; sputum and blood culture from peripheral were sent. Patient was started on empiric antibiotics and aggressive hydration. Blood cultures from peripheral access grew Elisabethkingia meningoseptica on the fi fth day. Patient was transferred to the intensive care unit for severe ARDS and septic shock where patient needed ventilator and vasopressors. Antibiotics were switched to intravenous levofi oxacin, and given intravenous corticosteroid for management of severe ARDS. Patient showed excellent treatment response to intravenous levofi oxacin and was weaned off ventilator on day 10 and vasopressors on day 4. Discussion: Healthcare associated E meningoseptica infection has been reported to have higher mortality compared to community acquired infection. E meningoseptica is a multidrug-resistant organism, as seen in our case, it is resistant to ß-lactam antibiotics and carbapenem. By given appropriate antibiotic and corticosteroid for management of severe ARDS, patient had a good outcome Lessons Learnt: We have to consider possibility of healthcare associated E meningoseptica infection, especially in an immunocompromised host, because failure to select appropriate antibiotics could lead to fatal consequences.
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