Elizabethkingia anophelisinfection in an infant: an unusual presentation

Abstract

A 7-month-old male infant presented with history of fever for 2 weeks, multiple ecchymotic patches over face, trunk and lower limbs, and one episode of seizure. The infant had shock, respiratory failure, severe anaemia, thrombocytopenia and temporoparietal haematoma on CT scan of the head. He was managed with supportive care and broad-spectrum empiric antibiotics. Two consecutive blood cultures grew Elizabethkingia anophelis, sensitive only to piperacillin–tazobactam. The infant responded to therapy and was discharged after 2 weeks of hospital stay. Repeated coagulation studies done to rule out an underlying bleeding disorder were negative. There was no clue in favour of non-accidental trauma. We report this case to highlight the unusual clinical presentation of this emerging pathogen. Mostly reported in outbreaks from surgical and post-operative intensive care units, it was worrisome to find this infant presenting with community-acquired E. anophelis infection.

Central Line-Associated Bloodstream Infection Due to Elizabethkingia anophelis: Case Report and Literature Review on Pediatric Infections

“…In a Medline/Pubmed searching the keywords ''Elizabethkingia anophelis pediatric infections''we found only 21 previously reported cases [5,7,[10][11][12][13][14][15][16][17][18][19]. Our case is the first pediatric E. anophelis infection described in Europe.…”

The First Reported Case of Elizabethkingia anophelis From Nepal

“…The patient we encountered developed pneumonia and subsequently succumbed to it. Atypical presentations, including vascular injury and thrombocytopenia due to sepsis with subsequent central nervous system (CNS) hematoma, have also been reported in infants [ 12 ]. Given all the studies in consideration of its relatively recent discovery, further studies to solidify its pathogenesis, epidemiology, and public health concerns need to be further addressed.…”

Biofilm formation and antibiotic sensitivity in Elizabethkingia anophelis

“…For an Elizabethkingia infection, successful treatment has been described using piperacillin-tazobactam. An infant’s unusual presentation of E. anophelis infection indicated the pathogen was sensitive only to piperacillin-tazobactam ( Mantoo et al., 2021 ). After antibiotic treatment was changed to piperacillin-tazobactam, the patient soon recovered and was discharged ( Mantoo et al., 2021 ).…”

“…An infant’s unusual presentation of E. anophelis infection indicated the pathogen was sensitive only to piperacillin-tazobactam ( Mantoo et al., 2021 ). After antibiotic treatment was changed to piperacillin-tazobactam, the patient soon recovered and was discharged ( Mantoo et al., 2021 ). According to a report by Wang et al., the antimicrobial susceptibilities of piperacillin-tazobactam were high at 86.5% ( Wang et al., 2020 ).…”

“…infection indicated the pathogen was sensitive only to piperacillin-tazobactam (Mantoo et al, 2021). After antibiotic treatment was changed to piperacillin-tazobactam, the patient soon recovered and was discharged (Mantoo et al, 2021).…”