Cerebral Salt Wasting Due to Bacteremia Caused by Elizabethkingia meningoseptica: A Case Report

Abstract

Introduction:Elizabethkingia meningoseptica is a Gram-negative Bacillus associated with various nosocomial infections. These bacteria cause meningitis, sepsis, bacteremia, pneumonia, infections of the skin and soft tissue, ocular infections, sinusitis, epididymitis, and endocarditis. They can be opportunistic pathogens in newborns and immunocompromised patients.Case Presentation: The current study reported a case of bacteremia caused by E. meningoseptica in an infant presented with clinical presentations suggestive of necrotizing fasciitis with cerebral salt wasting and disseminated intravascular coagulation. Based on clinical diagnosis and preliminary blood culture report, the patient started receiving intravenous antibiotic (cefepime plus fludrocortisone) and fluid therapy for electrolyte imbalance. The patient also had fasciotomy and an amputation through the distal phalanges due to necrotizing fasciitis. The patient improved clinically after eight weeks of treatment. Conclusions: E. meningoseptica bacteremia is commonly associated with complications; therefore, an appropriate and adequate antibiotic therapy, and also intensive care procedures and multidisciplinary interventions were crucial for the management of this case.

Epidemiology and Characteristics of Elizabethkingia spp. Infections in Southeast Asia

“…infections in Indonesia only appeared in the past couple of years. In Malang, Indonesia, a three-month-old infant presented to the Emergency Department of a tertiary hospital with a history of a 15-day fever associated with lethargy [ 13 ]. The patient was diagnosed with necrotizing fasciitis with cerebral salt wasting and disseminated intravascular coagulation.…”

“…The Gram-negative bacteria of the genus Elizabethkingia have recently emerged as an important pathogen in hospital-acquired infections and are generally associated with high mortality [ 1 ]. Recent literature has reported several cases of severe infection in humans owing to this organism, with neonatal meningitis most commonly presented in children [ 2 ], accompanied by a range of other clinical manifestations such as septicemia and bacteremia [ 3 , 4 ], osteomyelitis [ 5 ], urinary tract infections [ 6 , 7 ], endogenous endophthalmitis [ 8 ], endocarditis [ 9 ], epididymo-orchitis [ 10 ], pulmonary abscess [ 11 ], necrotizing fasciitis [ 12 , 13 ], cystic fibrosis [ 14 ], hydrocephalus [ 15 ], and secondary infections with a high mortality rate, particularly in immunocompromised patients [ 16 ]. Elizabethkingia meningoseptica infections have also been associated with COVID-19 patients [ 17 ].…”

A Clinical Case of Lower Respiratory Tract Infection Caused by Elizabethkingia Meningoseptica in a Child With Cerebral Palsy

“…6. Патогенез развития и прогрессирования нутритивных нарушений на фоне церебрального паралича эндокардит [19], эпидидимоорхит [20], абсцесс легкого [21], некротизирующий фасциит [22], муковисцидоз [23], гидроцефалия [24] и вторичные инфекции с высокой смертностью, особенно у пациентов с ослабленным иммунитетом [25]. Инфекции Elizabethkingia meningoseptica также были среди больных с COVID-19 [26].…”