Abstract:

This article reports a case of Erysipelothrix rhusiopathiae bloodstream infection in a patient with underlying liver cirrhosis. The patient, a pig farmer, was admitted to the hospital due to one-week history of fatigue. Physical examination showed mild icterus of the skin and mucous membranes, abdominal distension, and positive shifting dullness. The findings of laboratory studies included a white blood cell count of 2.8×10⁹/L, a platelet count of 21×10⁹/L, a C-reactive protein level of 57.44 mg/L, and a total bilirubin level of 57.33 μmol/L. Abdominal ultrasonography revealed liver cirrhosis, cholecystolithiasis, splenomegaly and ascites. On hospital day 2, the patient developed a fever with a maximum temperature being 38.5 ℃ and blood pressure dropped to 80/45 mmHg. Blood cultures were immediately taken, followed by prompt fluid resuscitation, empirical anti-infective therapy with piperacillin-tazobactam, and symptomatic supportive treatment. The diagnosis of Erysipelothrix rhusiopathiae bloodstream infection in the context of liver cirrhosis was confirmed by blood culture results. Piperacillin-tazobactam was continued in accordance with drug susceptibility testing results. The patient achieved clinical improvement and was discharged. Oral cephalexin was prescribed after discharge, and favorable outcomes were observed during follow-up. In this paper, we conducted a retrospective analysis of this case and reviewed relevant domestic and international literature, as well as analyzed the general characteristics, clinical manifestations, laboratory testing results, treatment and prognosis of bloodstream infection caused by Erysipelothrix rhusiopathiae in patients with liver cirrhosis, so as to improve the physician’s understanding of this condition.

Key words: Liver cirrhosis, Erysipelothrix rhusiopathiae, Bloodstream infection, Clinical characteristics