Elizabethkingia meningosepticum Isolated from Pleural Fluid: A Diagnostic Dilemma

Abstract

The nomenclature of Elizabethkingia meningosepticum has evolved over the years from Flavobacterium meningosepticum (CDC-IIa) in 1959 to Chryseobacterium meningosepticum in 1994. This was based on phylogenetic and phenotypic data. 1 Based on 16S ribosomal ribonucleic acid (rRNA) sequence in 2005, 2 the nomenclature was again changed to E. meningosepticum after its discoverer Elizabeth O. King. E. meningosepticum is considered the most pathogenic member of this genus. 3 It is a ubiquitous organism, which has rarely been reported in cases of pneumonia, endocarditis, wound infections, post-operative bacteraemia and meningitis. 4 Most E. meningosepticum infections in adults are hospital acquired and occur in immunocompromised host. It is a Gram-negative organism but inherently resistant to many antimicrobial agents commonly used to treat infections caused by Gramnegative bacteria. 1 Treatment may be difficult; therefore, definitive therapy for clinically significant isolates should be guided by antimicrobial susceptibility result. case reportAn 18-year-old female, an inmate of a residential facility for mentally challenged, presented to the out-patient service of Department of Chest and TB of our hospital with a history of fever, right-sided chest pain, dyspnoea along with cough and expectoration since two weeks. There was no past history of TB, asthma, diabetes, hypertension or urinary complaints. Informed consent was taken from the guardian and the patient was examined. On examination, she was conscious and oriented with poor general hygiene; vitals were stable. On general physical examination, generalised oedema and pallor were noted. Respiratory system