Bacteremic cholangitis due to Raoultella planticola complicating intrahepatic bile duct stricture 5 years post-laparoscopic cholecystectomy: a case report

ConclusionsAn in-depth search of the current literature did not yield other similar cases ofR. planticola infections. Moreover, to the best of our knowledge, our case is the first case ofR. planticola isolated from post-endoscopic retrograde cholangiopancreatography (ERCP) as part of biliary sepsis not associated with gastroenteritis. The late onset of the infection in our patient and the results of thein silico analysis suggest thatR. planticola may have survived exposure to the host immune system through the creation of an intracellular biofilm or in a non-culturable but viable state (NCBV) for the 5-year period. Thein silico analysis also suggests that biofilms, enterobactin, and mucoid phenotype may play a role in the pathogenesis ofR. planticola. However, further research is needed to illuminate the significance of pili, capsule biosynthesis, and lipopolysaccharide (LPS) in the virulence ofR. planticola. Lastly, as our patient did not have any risk factors previously associated withR. planticola, we suggest that biliary tract stricture, cholecystitis, and prior surgery may be possible novel risk factors.
Source: Journal of Medical Case Reports - Category: General Medicine Source Type: research