RESUMO
Abstract Eggerthella lenta is a gram-positive anaerobic bacillus that has been associated with life-threatening infections. Bacteremia is always clinically significant and is mostly but not always associated with gastrointestinal disease. We present a unique case of abrupt deterioration and rapid development of septic shock secondary to periurethral abscess caused by E. lenta infection. This case highlights the atypical clinical presentation, risk factors, uncommon source of infection, challenges in therapy, and outcome of this infrequent infection. There is still a gap in the understanding of E. lenta pathogenicity, and more literature is needed to establish clear management recommendations.
Assuntos
Humanos , Masculino , Doenças Uretrais/diagnóstico por imagem , Bacteriemia/microbiologia , Actinobacteria/isolamento & purificação , Abscesso/diagnóstico por imagem , Doenças Uretrais/tratamento farmacológico , Tomografia Computadorizada por Raios X , Fatores de Risco , Infecções por Bactérias Gram-Positivas/diagnóstico , Infecções por Bactérias Gram-Positivas/microbiologia , Actinobacteria/classificação , Infecção Pélvica/diagnóstico , Infecção Pélvica/microbiologia , Abscesso/microbiologia , Abscesso/tratamento farmacológico , Pessoa de Meia-Idade , Antibacterianos/uso terapêuticoRESUMO
Abstract: Vancomycin is the first-line agent for the treatment of bacteremia, endocarditis, pneumonia, cellulitis, and osteomyelitis. Pancytopenia is an uncommon adverse effect of vancomycin therapy, with only a few cases of vancomycin-related neutropenia and pancytopenia described in the literature. We describe a case of a 56-year-old man who was diagnosed with chronic paraspinal abscess and started on intravenous vancomycin. He was re-admitted two weeks later with new-onset pancytopenia. Discontinuation of vancomycin resulted in improved cell counts. Physicians should monitor cell counts in patients who are on long-term intravenous vancomycin.