Leclercia adecarboxylata bacteremia in a trauma patient: case report and review of the literature.
BACKGROUND
Leclercia adecarboxylata is a rarely described gram-negative pathogen. Since the advent of rapid molecular typing techniques, L. adecarboxylata has been described in 23 case reports, often associated with polymicrobial infections or in immunosuppressed hosts.


METHODS
A case is described and previous cases of L. adecarboxylata infection are reviewed.


METHODS
A 55-year old male victim of trauma developed septic shock several days after presentation to the emergency department. Blood and central vein catheter cultures grew L. adecarboxylata; Haemophilus influenzae and Streptococcus pneumoniae were present in bronchoalveolar lavage samples. With aggressive hemodynamic and ventilator support in addition to antibiotic therapy, the patient cleared the catheter-related blood stream infection. After a challenging intensive care unit stay, the patient eventually was discharged to an inpatient rehabilitation unit.


CONCLUSIONS
An L. adecarboxylata catheter-related blood stream infection developed in the setting of both underlying immunosuppression and polymicrobial infection. As molecular typing techniques continue to improve, L. adecarboxylata is likely to be an increasingly recognized gram-negative pathogen. Interactions between L. adecarboxylata infection, immunosuppression, and polymicrobial infections remain to be elucidated.
Department of Surgery, University of Virginia Health System, Charlottesville, Virginia, USA. JDForrester84@gmail.com
Joseph Derek
JD
Forrester
Josh
J
Adams
Robert G
RG
Sawyer
D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D016470:Bacteremia / Q000188:drug therapy; D002407:Catheterization, Swan-Ganz / Q000009:adverse effects; D060085:Coinfection / Q000150:complications; D004359:Drug Therapy, Combination; D004755:Enterobacteriaceae; D004756:Enterobacteriaceae Infections / Q000150:complications* / Q000188:drug therapy; D006801:Humans; D016867:Immunocompromised Host; D007262:Infusions, Intravenous; D008297:Male; D008875:Middle Aged; D009894:Opportunistic Infections / Q000150:complications* / Q000188:drug therapy; D012772:Shock, Septic / Q000188:drug therapy; D016896:Treatment Outcome; D014947:Wounds and Injuries / Q000382:microbiology*
D000900:Anti-Bacterial Agents