Groszek Patrycja*, Sobocki Jacek, Kaczanowska Joanna, Sulikowska Agnieszka, Majewska Krystyna and Omidi Mohammad
Department of General Surgery and Clinical Nutrition, Independent Public Clinical Hospital, PolandFulltext PDF
Background: Parenteral nutrition is an invasive treatment, which carries high risk of infection. Catheter related bloodstream infections are the most serious compilations of parenteral nutrition therapy.Contamination of the hub of a central line may cause bacteremia and sepsis. We present the case of Leuconostoc mesenteroides bacteremia in a parenteral-fed patient in the home-care setting. To our knowledge, it is the first described case of central line's salvage from this pathogen in an immunocompromised permanently parenterally fed adult patient.Case
Presentation: A 29-year-old man with features of malnutrition due to infection of a central line was admitted to the hospital on emergency. The patient reported abdominal pain, fever and symptoms of dysuria for 3 weeks. Standard tests were performed including blood for culture sampled from the central line and the peripheral vein. Blood cultures detected central line.Parenteral nutrition administered via the peripheral venous route was introduced. Firstly, bacteremia was empirically treated with antibiotics such as vancomycin and imipenem+cilastatine, secondly switched to ampicillin according to the antibiogram and with Clindamycin administered to the central line followed by alcohol lock. Control cultures confirmed successful treatment. Parenteral nutrition was administered to the central line and transfusion went uneventful for two days.Conclusion: Successful treatment of opportunistic CRBSI with catheter salvage can be feasible even in immunocompromised patients. In the central lines treatment it is important to consider risks and benefits resulting from its removal.
Central venous catheter; Leuconostoc; Home parenteral nutrition; Sepsis
Patrycja G, Jacek S, Joanna K, Agnieszka S, Krystyna M, Mohammad O. Successful Treatment of Leuconostoc mesenteroides Infection of the Broviac Catheter in a Patient on Home Parenteral Nutrition via Central Venous Access. Ann Clin Case Rep. 2019; 4: 1648.