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Journal of Clinical Microbiology, June 2000, p. 2450-2452, Vol. 38, No. 6
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.

Recurrent Bacteremic Peritonitis Caused by Enterococcus cecorum in a Patient with Liver Cirrhosis

Po-Ren Hsueh,1,2 Lee-Jene Teng,1,3 Yu-Chi Chen,1 Pan-Chyr Yang,2 Shen-Wu Ho,3 and Kwen-Tay Luh1,2,*

Departments of Laboratory Medicine1 and Internal Medicine,2 National Taiwan University Hospital, and School of Medical Technology, National Taiwan University College of Medicine,3 Taipei, Taiwan

Received 29 November 1999/Returned for modification 18 February 2000/Accepted 6 March 2000

Enterococcus cecorum (formerly Streptococcus cecorum), originally isolated from poultry intestines, has rarely been encountered in human diseases. A 60-year-old man with liver cirrhosis and hepatocellular carcinoma developed peritonitis on the seventh day of his hospitalization. Cultures of one blood sample and one ascites fluid sample obtained on that day both grew E. cecorum. The patient received intravenous cefoxitin therapy and initially responded well. Unfortunately, another episode of peritonitis associated with septic shock developed 24 days after the start of treatment, and culture of one blood specimen yielded the same organism. The isolates were identified by the conventional biochemical tests, the API Rapid ID 32 Strep system, and the API ZYM system (both systems from bioMerieux, Marcy L'Etoile, France) and were further confirmed by cellular fatty acid chromatography and 16S rRNA gene partial sequencing. The identical biotype, antibiotype, and random amplified polymorphic DNA pattern of the three isolates documented the long-term persistence of this organism in the patient. To the best of our knowledge, this is the first clinical description of recurrent bacteremic peritonitis caused by E. cecorum.

* Corresponding author. Mailing address: Department of Laboratory Medicine, National Taiwan University Hospital, No. 7 Chung-Shan South Rd., Taipei, Taiwan. Phone: 886-2-23562149. Fax: 886-2-23224263. E-mail: luhkt{at}ha.mc.ntu.edu.tw.

Journal of Clinical Microbiology, June 2000, p. 2450-2452, Vol. 38, No. 6
0095-1137/00/$04.00+0
Copyright © 2000, American Society for Microbiology. All rights reserved.


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