Elizabethkingia miricola Recovered from a Peritoneal Fluid Sample – A Clinical Case Report with Diagnostic Challenges

Abstract

BACKGROUND: Elizabethkingia spp. are Gram-negative, non-spore-forming bacteria that used to be rarely encountered but now they are of growing clinical significance. Furthermore, the diagnostic challenges to identification impede the complete elucidation of their epidemiology and association with human diseases. CASE REPORT: A 64-year-old man with liver cirrhosis due to alcohol abuse presented with fatigue, abdominal swelling, and bilateral scrotal edema. A peritoneal fluid sample was cultured and subject to a number of identification methods – API 20 NE (bioMerieux), automated Vitek-2 Compact (bioMerieux), MALDI-TOF MS (Vitek-MS, bioMerieux), and 16S rRNA gene sequencing. A final diagnosis of bacterascites was made on the basis of clinical, laboratory, and microbiological findings. CONCLUSION: To the best of our knowledge, this is the first report of Elizabethkingia miricola being cultured from a peritoneal fluid sample in an immunocompromised host thus pointing to the emerging pathogenic role of the bacterium in patients with liver cirrhosis and ascites.