Disseminated Infection Caused by Eggerthella lenta in a Previously Healthy Young Man: A Case Report

Anaerobic bacteria are the predominant normal flora of the mucous membranes which may cause life-threatening disseminated infections and are often difficult to culture from infected sites. Eggerthella (previously known as Eubacteria species) is an anaerobic, nonsporulating, nonmotile, Gram-positive rod that is found in the human colon and feces and has been isolated from various other clinical specimens. We report a case of complicated disseminated anaerobic bacterial infection with Eggerthella lenta in a healthy immunocompetent man causing multiple brain abscesses, liver abscesses, necrotizing pneumonia, and osteomyelitis of the left radial bone. He was successfully treated with empiric penicillin G and metronidazole. 1. Introduction Anaerobic bacteria may cause life-threatening disseminated infections and are often difficult to culture from infected sites. We report a case of complicated disseminated anaerobic bacterial infection with Eggerthella lenta, previously known as Eubacteria species in a healthy immunocompetent man causing multiple brain abscesses, liver abscesses, necrotizing pneumonia, and osteomyelitis of the left radial bone. He was successfully treated with empiric penicillin G and metronidazole. 2. Case Presentation A 19-year-old male was transferred to our facility from a hospital in New York City where he had initially presented with fever, fatigue, weakness, loss of appetite, nonproductive cough, nausea, vomiting, and unintentional weight loss of about 20 pounds (9.07 Kilograms) over a two-week duration. His past medical history was significant for asthma and three episodes of pneumonia during childhood. His mother has common variable immunedeficiency (CVID) and antiphospholipid syndrome. The patient denied ingestion of raw food, exposure to animals, recent travel, or sick contacts and reported safe sex with one partner. He denied use of tobacco, alcohol, and injection drug use. On admission to the hospital in New York City he had a temperature of 40.0°C, heart rate of 126 beats per minute, respiratory rate of 20, blood pressure of 98/56, and oxygen saturation of 100% on room air. Physical examination was significant for crackles at the left base, hyperreflexia of the deep tendons of the upper and lower extremity with ankle clonus. Two sets of blood cultures were reported to be positive for Eggerthella lenta. Laboratory results were significant for a white-blood cell count of 15,700/mm3 with 78% neutrophils. His urinalysis and kidney function tests were within normal range, and liver function tests were mildly elevated. The chest