DOI: 10.12890/2024_004758

A case of Raoultella ornithinolytica cholangitis in a liver transplant recipient

Authors

  • Daan A. De Coster Gastroenterology Department, John Hunter Hospital, Newcastle, Australia
  • Melissa Carroll Gastroenterology Department, John Hunter Hospital, Newcastle, Australia
  • James Lavender Gastroenterology Department, John Hunter Hospital, Newcastle, Australia
  • Robert Gibson Gastroenterology Department, John Hunter Hospital, Newcastle, Australia; School of Medicine and Public Health, University of Newcastle, Newcastle, Australia

decosterdaan@doctors.org.uk

Keywords

Liver transplant, transplant complications, cholangitis, rare infections, Raoultella ornithinolytica

Abstract

Background: We present the first documented case of Raoultella ornithinolytica bacteraemia in a patient with liver transplantation. R. ornithinolytica is a Gram-negative anaerobic bacterium found in aquatic environments in fish and birds, and is source of nosocomial infection causing pneumonia, enteritis, cholangitis or urinary infections, associated with surgical interventions in a hospital setting.
Case description: A 44-year-old female presented with a 2-day history of fever, rigors, and headache. Her past medical history was significant for having received three orthotopic liver transplants due to Wilson’s disease over a 20-year period. Her physical examination was unremarkable besides stigmata of prior liver transplantation. Blood tests revealed mild elevations in liver function markers and raised inflammatory markers. R. ornithinolytica was eventually isolated from blood cultures. Subsequent magnetic resonance cholangiopancreatography (MRCP) demonstrated new left intrahepatic ductal dilation with heterogeneous peripheral enhancement. The proximal location of the cholangitis explained the lack of abdominal pain or tenderness. The patient was treated with appropriate antibiotic therapy and cultures were negative on day 2. The patient recovered without further intervention.
Conclusion: Seldom encountered R. ornithinolytica is uncommonly pathogenic but should be considered in patients receiving immunosuppressants and those with complex surgical anatomy.

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References

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Published

2024-09-06

Issue

Vol. 11 No. 10 (2024)

Categories

How to Cite

1.
De Coster DA, Carroll M, Lavender J, Gibson R. A case of Raoultella ornithinolytica cholangitis in a liver transplant recipient. EJCRIM [Internet]. 2024 Sep. 6 [cited 2026 Nov. 3];11(10). Available from: https://ejcrim.com/index.php/ejcrim/article/view/4758

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