<i>Raoultella planticola</i>Bacteremia-Induced Fatal Septic Shock and Sepsis-Induced Coagulopathy in a Patient with Pancreatic Cancer: A Case Report and Literature Review

• 作者: Konul Hajiyeva Mehmet Oral
• 来源期刊: 临床医学国际期刊(英文)
• 学科: 医学
• 关键词: Antibiotic Resistance BACTEREMIA Sepsis
• 年，卷（期）: 2021,（1）
• 页码范围: 36-42
• 页数: 7页
• 分类号: R73

摘要

Background: <em>Raoultella planticola</em> is a gram-negative rod-shaped bacterium commonly found in water and soil and considered to be a rare and possibly underestimated cause of severe human infection. Its presence should be suspected in older patients with a history of cancer, immune suppression and recent exposure to traumatic injuries or invasive medical procedures. Case presentation: A 78-year-old male with a history of hypertension was diagnosed with pancreatic adenocarcinoma. Whipple procedure (pancreaticoduodenectomy) was performed afterwards. On the 8th day of surgery, the patient was admitted to our tertiary ICU with septic shock. His initial Sequential Organ Failure Assessment (SOFA) score was 12 with predicted mortality 95.7%. Empirical antibiotic therapy with colymicin, meropenem and teikoplanin was administered immediately and two sets of blood cultures were obtained. Patient developed refractory septic shock despite the addition of vasopressin and the patient’s condition continued to deteriorate. Patient died on the third day of sepsis. His blood culture was positive for <em>R.</em> <em>planticola</em>, which was identified using the VITEK-2 biochemical identification system. Conclusions: Clinicians should be aware of fatal unusual infections in immunocompromised patients.