title: Ascending cholangitis presenting with Lactococcus lactis cremoris bacteraemia: a case report.
abstract: BACKGROUND
  A case of Lactococcus lactis cremoris causing cholangitis is described. This Gram-positive organism is not routinely considered to be pathogenic in immunocompetent individuals. To our knowledge, this is the thirteenth report of invasive infection and the first of cholangitis to be reported in association with this organism.
  
  
  METHODS
  A 72-year-old patient presented with Charcot's triad and was demonstrated to have cholangitis with Lactococcus lactis cremoris bacteraemia. Biliary drainage was achieved through endoscopic retrograde cholangiography. Antibiotic therapy with multiple agents was necessary.
  
  
  CONCLUSIONS
  This report provides corroboration of evidence that Lactococcus lactis cremoris is a potential pathogen in immunocompetent adults. There remains a debate about the most appropriate empirical antibiotic therapy in this condition. In the light of this case, it is important to keep an open mind to potential pathogens.
authors.affiliation: Tropical and Infectious Diseases Unit, Royal Liverpool and Broadgreen University Hospitals Trust, Prescot Street, Liverpool, L7 8XP, UK. janedavies4@nhs.net.
authors.forename: Jane
authors.initials: J
authors.lastname: Davies
authors.forename: Michael David
authors.initials: MD
authors.lastname: Burkitt
authors.forename: Alastair
authors.initials: A
authors.lastname: Watson