Septicemia caused by Eikenella corrodens in a previously healthy male: A case report.

Abstract

Rationale: The bacterium Eikenella corrodens is part of the normal microbiota of the oropharynx. It typically causes disease in patients with bite wound, immunosuppression, and those undergoing surgery, but rarely affects healthy individuals. Despite the rarity of infection induced by E corrodens, early diagnosis and therapy are important.

Patient concerns: The study reports a case of septicemia caused by E corrodens in a previously healthy male individual. The patient was admitted to hospital due to fever, fatigue, and mild cough lasting 4 weeks. Physical examination was unremarkable. Chest and abdominal computed tomography showed no obvious infiltrates. Transthoracic echocardiography did not reveal excrescence on the aortic valve.

Diagnoses: E corrodens was isolated from blood, proving its pathogenic potential. To confirm the pathogen, 16S rRNA gene sequencing was performed directly from the blood culture, obtaining a sequence that aligned with E corrodens with a homology percentage of 99.8%. The patient was diagnosed as septicemia caused by E corrodens.

Interventions: The patient was treated with moxifloxacin (0.4 g once daily) intravenously for 3 days, but continued to experience recurrent fever. Following the diagnosis of septicemia caused by E corrodens, antibiotic treatment was switched to cefoperazone-sulbactam (SCF; 3 g every 8 h) for 14 days in total.

Outcomes: Fever, fatigue, and other discomfort were relieved after 1 day of treatment with SCF. The white blood cell count, C-reactive protein concentration, and procalcitonin levels were gradually normalized after 14 days of treatment with SCF. Blood culture was performed after 14 days of treatment with SCF, yielding negative results.

Lessons: The present case report highlights that E corrodens should be considered as a cause of septicemia even in healthy individuals. For the avoidance of delayed diagnosis, it is vital to perform blood culture before initiating antibiotic treatment. Furthermore, SCF should be considered as a preferred treatment option for such infections.