A Case of Sphingobacterium multivorum Bloodstream Infection in a Critically-Ill Patient.

Abstract

A 40-year-old male with poorly controlled diabetes mellitus presented to our ICU with right thigh cellulitis and diabetic ketoacidosis (DKA). Subsequently, he developed inferior wall myocardial infarction and right ventricular dysfunction. On examination, he was in altered sensorium, hemodynamically unstable, and had respiratory distress. He was managed for all the above-mentioned issues, which comprised management of DKA and acute coronary syndrome (dual anti-platelets, heparin, statins) and included life support therapies in the form of invasive mechanical ventilation, central line placement, IV fluid resuscitation (guided by two-dimensional echocardiography, lung ultrasonography, and hemodynamic and oxygenation parameters), vasoactive drugs and other drugs such as anti-platelets, therapeutic heparinization, and IV insulin infusion for glycemic control (with emphasis on electrolytes also). The patient stayed in ICU for a prolonged period due to neuromuscular weakness, nosocomial infections, and ischemic cardiomyopathy. Later on, he developed a grade III sacral bedsore also. One of the bugs was S. multivorum cultured from his peripheral blood during an episode of high-grade fever.