Journal List > Ann Clin Microbiol > v.17(4) > 1078502

Hong, Shin, Yoon, and Kim: Spontaneous Bacterial Peritonitis with Septicemia with Providencia rettgeri and Clostridium perfringens

초록

We report a suspicious case of spontaneous bacterial peritonitis (SBP) caused by Providencia rettgeri and Clostridium perfringens in a patient with alcoholic cirrhosis. The patient presented with altered mentality and was taken to the emergency room. He was diag-nosed with SBP after abdominal paracentesis and computed tomography and was treated with ceftriaxone and metronidazole. The pathogens were identified under sus-picion of polymicrobial infection because of Gram-stain-ing discrepancies between broth from blood culture bot-tles and colonies on solid media. He died of septic shock despite transfer to the intensive care unit. Although we could not conclude which organism had the leading role in this case of SBP and septicemia, we did verify the importance of Gram staining in a microbiology laboratory in terms of quality assurance.

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Fig. 1.
Noncontrast abdominal computed tomography image showing ascites, hepatomegaly and diffuse wall thickening of the small bowels.
acm-17-123f1.tif
Fig. 2.
(A) Gram-positive and gram- negative rods from smear preparations of the positive aerobic blood culture bottle (Gram stain, ×1,000). (B) Gram-positive and gram-negative rods from smear preparations of the positive anaerobic blood culture bottle (Gram stain, ×1,000). (C) White and mucous colonies of Providencia rettgeri incu-bated for 24 hr at 35 o C in a 5% CO2 atmosphere on a blood agar plate. (D) Gram stain of P. rettgeri from smear preparations of the blood agar plate (×1,000). (E) Flat colonies with beta-hemolysis of C. perfringens incu-bated for 48 hr anaerobically on a Brucella agar plate. (F) Gram stain of Clostridium perfringens from smear preparations of the Brucella agar plate (×1,000).
acm-17-123f2.tif
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