A Rare Case of Raoultella planticola and Enterococcus casseliflavus Coinfection

Abstract

Raoultella planticola, a Gram-negative bacterium, is a nonmotile rod usually found in soil and aquatic environments. It can be found in association with gastrointestinal malignancy. Enterococcus casseliflavus is a rare vancomycin-resistant Enterococcus that is responsible for some bacteremia. Our case describes a unique presentation of colonization with both R. planticola and E. casseliflavus isolated from the biliary stent isolates of a patient with known pancreatic malignancy and concomitant E. casseliflavus bacteremia. This is the first case ever reported of infection with both species.

Enterococcus casseliflavus Infection: A Review of Clinical Features and Treatment

“…Infective endocarditis was the primary infection site in two cases, 9,10 and cholangitis was reported as the primary infection site in one case. 12 A retrospective cohort study of biliary infections with bacteremia found that E. casseliflavus constituted 12.5% of the Gram-positive bacteremia. 20 Three of the eleven patients had biliary tract infections prior to the onset of E. casseliflavus bacteremia.…”

“…30 Of the 11 case reports reviewed, five presented with bacteremia caused by E. casseliflavus and other organisms. 9,12,15,17,18 Cohort studies reported a high proportion (41.5-66.1%) of E. casseliflavus bacteremia cases with multiple bacterial species present, primarily other Gram-negative Enterobacteriaceae. 27,28,30 This feature is probably specific to E. casseliflavus bacteremia.…”