SHM Converge Scientific Abstract ePoster Gallery-The Lenta Bug and Its Big Bite: An Eggerthella Bacteremia Case Report

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Eggerthella lenta is a rare, slow-growing anaerobic Gram-positive rod that normally lives in the gastrointestinal tract but can cause serious bloodstream infection. The text emphasizes that anaerobic Gram-positive rods found in blood cultures should not be dismissed as contaminants, because E. lenta bacteremia is often clinically meaningful and can carry significant mortality.<br /><br />Across the cited reports and reviews, E. lenta is most often associated with underlying gastrointestinal or hepatobiliary disease, malignancy, diabetes, recent surgery or trauma, pressure ulcers, and polymicrobial infection. Its detection should prompt evaluation for an occult abdominal source, such as diverticular disease, abscess, or hepatobiliary pathology.<br /><br />The case report describes a 69-year-old woman who presented with chills, rigors, and mild respiratory symptoms. Initial workup suggested urinary tract infection, and she was treated with ceftriaxone and then amoxicillin-clavulanate. When one blood culture bottle later grew Gram-positive rods, it was first considered a contaminant. However, the organism was ultimately identified as E. lenta, and a second blood culture bottle also became positive. Urine cultures grew pan-sensitive E. coli, while abdominal and chest imaging did not reveal an acute source. She was admitted, switched to levofloxacin plus metronidazole, improved clinically, and completed a 10-day course.<br /><br />The literature review notes that E. lenta is generally susceptible to anaerobic-active antibiotics such as metronidazole, amoxicillin-clavulanate, carbapenems, vancomycin, cefoxitin, and clindamycin, though susceptibility to piperacillin-tazobactam and moxifloxacin may vary. Overall, early recognition, appropriate antimicrobial therapy, and investigation for a hidden gastrointestinal or hepatobiliary focus are critical to improving outcomes.

Asset Subtitle

Denise Fernandes

Meta Tag

Author List Denise Fernandes

Category Clinical Vignettes

Concept Eggerthella lenta

Concept Bloodstream Infection

Concept Blood Culture Contaminant

Concept Anaerobic Gram-Positive Rod

Concept Gastrointestinal Disease

Distinguished Non-Finalist

Presenter Organization Brown University Health, the Miriam Hospital

Presenting Author Denise Fernandes

Track Adult

Keywords

Eggerthella lenta

anaerobic Gram-positive rod

bloodstream infection

bacteremia

gastrointestinal disease

hepatobiliary disease

blood culture contaminant

metronidazole

occult abdominal source

polymicrobial infection

Eggerthella lenta

Bloodstream Infection

Blood Culture Contaminant

Anaerobic Gram-Positive Rod

Gastrointestinal Disease