Citrobacter braakii bacteremia-induced septic shock after colonoscopy preparation with polyethylene glycol in a critically ill patient: a case report

Yumoto, Tetsuya; Kono, Yoshiyasu; Kamoi, Chihiro; Iida, Atsuyoshi; Nose, Motoko; Sato, Keiji; Ugawa, Toyomu; Okada, Hiroyuki; Ujike, Yoshihito; Nakao, Atsunori

doi:10.1186/s12941-017-0201-5

Cited by 8 publications

(8 citation statements)

References 9 publications

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“…To date, there are only a limited number of documented C. braakii bloodstream infections reported in the literature. 2–7. Yumoto et al.…”

Section: Discussionmentioning

confidence: 99%

“…This patient was managed with empiric meropenem and subsequently de-escalated to ceftazidime therapy to complete a 10-day antibiotic course. 2 Gupta et al. describe the case of C. braakii bacteremia in a renal transplant patient treated with a 14-day course of levofloxacin and aztreonam antibiotic therapy.…”

Section: Discussionmentioning

confidence: 99%

“…Citrobacter braakii (C. braakii) specifically has been reported to cause sepsis in immunocompromised patients. 2 To date, there are no studies that compare the efficacy of treatment for this species so treatment of Citrobacter falls under treatment for any infection caused by the enterobacteriaceae species. 1 Aminoglycosides, fluoroquinolones, carbapenems, and fourth generation cephalosporins can all be used for managing infectious caused Citrobacter species.…”

Section: Introductionmentioning

confidence: 99%

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Citrobacter braakii CLABSI in a hematopoietic stem cell transplant patient

Tollkuci

Myers

2021

J Oncol Pharm Pract

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Introduction Citrobacter bacteria are gram-negative anaerobic bacilli commonly found in water, soil, food, and the intestinal tracts of animals and humans. Patients at highest risk of these nosocomial infections include neonates and adults who are ≥65 years of age, debilitated, or immunocompromised. Citrobacter braakii ( C. braakii), specifically, has been reported to cause sepsis in immunocompromised patients. Herein, we describe a case of an allogeneic stem cell transplant (SCT) adult patient with C. braakii bloodstream infection. Case Report We report our experience managing a central line-associated bloodstream infection (CLABSI) due to C. braakii in an allogeneic SCT patient. Management and Outcomes: Our patient was initially managed with cefepime. The central venous catheter (CVC) was removed. Blood cultures cleared 24 hours after antibiotic initiation. Therapy was transitioned to oral levofloxacin once susceptibilities resulted. Discussion The course of this patient highlights the important relationship between an unusual pathogen, C. braakii, in an immunocompromised allogeneic SCT patient. In our case, the source of the bacteremia was most likely a CLABSI given the positive catheter tip cultures. Although this report describes the successful utilization of cefepime and levofloxacin in the treatment of C. braakii infection, caution should be exercised when choosing empiric antimicrobial therapy as AmpC resistance. This clinical scenario can aid health care providers in making informed treatment decisions when faced with patients diagnosed with this relatively uncommon pathogen. Further reports should be published to determine C. braakii bacteremia management in hematopoietic stem cell transplant patients.

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“…To date, there are only a limited number of documented C. braakii bloodstream infections reported in the literature. 2–7. Yumoto et al.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Citrobacter braakii CLABSI in a hematopoietic stem cell transplant patient

Tollkuci

Myers

2021

J Oncol Pharm Pract

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“…There are rare cases of patients developing sepsis following bowel preparation. One case described a patient who developed septic shock immediately following completion of the preparation requiring aggressive resuscitation 11. This patient had proven bacteraemia in the form of blood cultures positive for Citrobacter braakii .…”

Section: Discussionmentioning

confidence: 99%

Bowel preparation agent inducing profound shock precolonoscopy

Loraine

2020

BMJ Case Rep

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A 73-year-old woman was admitted to the intensive care unit following vomiting and diarrhoea onset after completing oral bowel preparation prior to colonoscopy to investigate haematochezia. She had a history of severe chronic obstructive pulmonary disease, Crohn’s disease, diverticular disease, hypertension and dyslipidaemia. She was resuscitated with intravenous fluids, antibiotics and required epinephrine, norepinephrine and vasopressin infusions. She improved over her 4-day intensive care admission and was discharged to the general medical ward, but ultimately died 19 days after presentation.

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“…The PubMed and EMBASE databases were searched through May 2022 using the following terms and operators: [(Polyethylene glycol) OR (PEG)] AND (infection). Only 3 cases of bacteremia after ingestion of PEG have been reported, mainly due to bacterial translocation, and all patients had a history of chronic underlying diseases[ 2 - 4 ]. Herein, a case of septic shock after colonoscopy with PEG preparation in a healthy adult male with no underlying medical history was described.…”

Section: Introductionmentioning

confidence: 99%

Unexplained septic shock after colonoscopy with polyethylene glycol preparation in a young adult: A case report

Song¹,

Wu²,

Dong³

et al. 2022

World J Clin Cases

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BACKGROUND Colonoscopy has become a routine physical examination as people’s health awareness has increased. Polyethylene glycol (PEG) is greatly used in bowel preparation before colonoscopy due to its price and safety advantages. Septic shock after colonoscopy with PEG preparation is extremely rare, with only very few cases in critically ill patients. Herein, we describe a case of septic shock in a healthy young adult immediately following colonoscopy with PEG preparation. CASE SUMMARY A 33-year-old young adult presented to our hospital for colonoscopy with PEG bowel preparation due to recurrent diarrhea for 7 years. The male's previous physical examination showed no abnormal indicators, and colonoscopy results were normal; however, he exhibited septic shock and markedly elevated white blood cell, C-reactive protein, and procalcitonin levels on the second day after colonoscopy. Immediate resuscitation and intensive care with appropriate antibiotics improved his condition. However, the blood and stool cultures did not detect the pathogen CONCLUSION Septic shock after colonoscopy is rare, especially in young adults. The authors considered the possibility of opportunistic infections after PEG bowel preparation, and clinicians should monitor patients for the possibility of such complications

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Citrobacter braakii bacteremia-induced septic shock after colonoscopy preparation with polyethylene glycol in a critically ill patient: a case report

Cited by 8 publications

References 9 publications

Citrobacter braakii CLABSI in a hematopoietic stem cell transplant patient

Citrobacter braakii CLABSI in a hematopoietic stem cell transplant patient

Bowel preparation agent inducing profound shock precolonoscopy

Unexplained septic shock after colonoscopy with polyethylene glycol preparation in a young adult: A case report

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