Case Report: A case study of geriatric acute cholecystitis complicated by coinfection with Shewanella putrefaciens and Enterococcus faecium
Abstract
Background: Acute cholecystitis is a common abdominal condition mainly caused by enteric Gram-negative bacilli and Enterococcus species. Advances in microbial detection have highlighted infections by rare pathogens like Shewanella putrefaciens (S. putrefaciens), an opportunistic bacterium from aquatic environments affecting mainly immunocompromised or comorbid patients. Its clinical features, antibiotic resistance, and treatment remain unclear.
Case presentation: This article presents a case study of an 87-year-old female patient with a medical history of gallstones and previous endoscopic retrograde cholangiopancreatography (ERCP), who was admitted to the hospital due to "low back and leg pain." On November 14, 2023, she developed acute cholecystitis. Initial treatment consisted of cefoperazone/sulbactam and ciprofloxacin. Ultrasound-guided percutaneous transhepatic gallbladder drainage (PTGBD) was performed, revealing purulent bile that tested positive for S. putrefaciens and Enterococcus faecium (E. faecium). Based on susceptibility testing, the antibiotic regimen was adjusted to cefoperazone/sulbactam and vancomycin, which was administered until November 24, 2023. The patient's condition subsequently improved, and she was discharged from the hospital.
Conclusion: We documented the inaugural case of an elderly patient presenting with acute cholecystitis co-infected with S. putrefaciens and E. faecium. This case underscores the importance of integrating source control via…
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.