title: Relapsing sepsis episodes of Escherichia coli with CTX-M ESBL or derepressed ampC genes in a patient with chronic autoimmune pancreatitis complicated by IgG4 hypergammaglobulinaemia.
abstract: Bloodstream recurrent infections have been reported for a variety of opportunistic bacteria. These are often either catheter related or are caused by indwelling devices. A case of relapsing sepsis with two Escherichia coli strains carrying extended-spectrum β-lactamase and derepressed ampC genes is reported. The patient had seven episodes of bloodstream infections within 1 year and was diagnosed with chronic autoimmune pancreatitis and IgG4 hypergammaglobulinaemia. Abscesses were found in his spleen and pancreas cauda, which was finally resected. Relapses of bacteraemia with resistant enterobacteria should be considered during perioperative protection. Surgical removal of the infective focus could be curative.
authors: Eastern Finland Laboratory Centre Joint Authority Enterprise (ISLAB), Mikkeli District Laboratory, Mikkeli, Finland; Department of Bacteriology and Immunology, Haartman Institute, University of Helsinki, Helsinki, Finland.
authors: T
authors: T
authors: Tuuminen
authors: Bacterial Infections Unit, Department of Infectious Diseases, National Institute for Health and Welfare, Turku, Finland.
authors: M
authors: M
authors: Österblad
authors: Department of Medicine, Kuopio University Hospital, Finland.
authors: S
authors: S
authors: Hämäläinen
authors: Imaging Center, Clinical Pathology, Kuopio University Hospital, Finland; Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland; Biocenter Kuopio and Cancer Center of Easter Finland, University of Eastern Finland, Kuopio, Finland.
authors: R
authors: R
authors: Sironen
keywords: Autoimmune pancreatitis; ESBL; IgG4 hypergammaglobulinaemia; bacteraemia; relapsing sepsis