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

Ann Clin Microbiol 2014;17(4):123-127.

Published online: 5 December 2014

DOI: https://doi.org/10.5145/ACM.2014.17.4.123

Spontaneous Bacterial Peritonitis with Septicemia with Providencia rettgeri and Clostridium perfringens

Sung Kuk Hong1, Sue Shin2, 3, Jong-Hyun Yoon2, 3, Eui-Chong Kim3

1Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea

2Department of Laboratory Medicine, Boramae Hospital, Seoul, Korea

3Department of Laboratory Medicine, Seoul National University College of Medicine, Seoul, Korea

Correspondence: Sue Shin, Department of Laboratory Medicine, Seoul National University Boramae Hospital, 20, Boramae-ro 5-gil, Dongjak-gu, Seoul 156-707, Korea. (Tel) 82-2-870-2602, (Fax) 82-2-870-2620, (E-mail) jeannie@snu.ac.kr

Received 1 March 20141 September 2014       Accepted 2 September 2014

Copyright © 2014 The Korean Society of Clinical Microbiology

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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.

Keywords: Clostridium perfringen, Providencia rettgeri, Spontaneous bacterial peritonitis

REFERENCES

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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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