Weissella confusa bacteremia in a liver transplant patient with hepatic artery thrombosis.

摘要: A 54-year-old man with a history of nonalcoholic steatohepatitis and hepatocellular carcinoma presented 2 months after an orthotopic liver transplant fever abdominal pain. Two weeks earlier, he had hepatic artery thrombosis biliary stricture, for which stent were placed. Laboratory workup was significant leukocyte count 7800/mcL 92% segmented neutrophils, hemoglobin 9.4 g/dL, alanine aminotransferase 98 U/L, aspartate 72 alkaline phosphatase 358 albumin 2.8 mg/dL, total bilirubin 1.6 mg/dL. computed tomography scan the abdomen pelvis revealed multiple small fluid collections in consistent bilomas, angiogram showed complete occlusion common artery. sets blood cultures positive organism initially identified by MicroScan(®) analysis as α-hemolytic Streptococcus species that resistant to vancomycin. Further testing confirmed Weissella confusa days later. W. is gram-positive coccobacillus may be misidentified Lactobacillus when cultured. It commonly found sewage, carrots, sugar cane, fermented foods, intestinal flora. Although only 4 cases clinical infection have been described previously, has isolated from stool patients, underreported cause owing improper identification. As it can these immunosuppressed hosts, identification this paramount because vancomycin resistant, incorrect could lead antimicrobial selection ultimately worsened patient morbidity or mortality.