CASE REPORT: LIVER ABSCESS-ASSOCIATED BACTEREMIA CAUSED BY E. COLI AND E. RAFFINOSUS

Tóm tắt

We report a clinical case of a 77-year-old male patient diagnosed with bloodstream infection accompanied
by a liver abscess caused by Escherichia coli and Enterococcus raffinosus. The patient had a medical history
of hypertension and benign prostatic hyperplasia. He initially presented with fever and right upper quadrant
abdominal pain. On the third day of illness, he was admitted to a district-level hospital with a presumptive
diagnosis of sepsis. After two days of empirical antibiotic treatment without clinical improvement, he was referred to a provincial hospital, where the diagnosis of sepsis with liver abscess was made, along with known comorbidities of benign prostatic hyperplasia and hypertension. He received a combination of cefoperazone, gentamicin, and metronidazole; however, the patient remained febrile, and blood cultures grew E. coli (antibiotic susceptibility testing was not available). He was subsequently transferred to Bach Mai Hospital. Initial treatment with meropenem and percutaneous aspiration of the liver abscess led to
gradual clinical improvement. Blood and abscess fluid cultures at our hospital revealed coinfection with E.
coli and E. raffinosus. Targeted antibiotic therapy with meropenem and vancomycin was initiated, resulting
in marked clinical improvement and eventual hospital discharge. This case underscores the importance of considering polymicrobial infections and the crucial role of early source control in managing intraabdominal sepsis.