Enterobacter cloacae Sacroiliitis with Acute Respiratory Distress Syndrome in an Adolescent.
- Author:
Jin Soo KIM
1
;
Jeong Hee KO
;
Seunghun LEE
;
Seok Chol JEON
;
Sung Hee OH
Author Information
- Publication Type:Case Report
- Keywords: Enterobacter cloacae; Sepsis; Sacroiliitis; Acute respiratory distress syndrome; Adolescent
- MeSH: Adolescent*; Anti-Bacterial Agents; Ceftriaxone; Dyspnea; Enterobacter cloacae*; Fever; Hip; Hospitalization; Humans; Magnetic Resonance Imaging; Male; Methylprednisolone; Radiography; Respiratory Distress Syndrome, Adult*; Sacroiliitis*; Sepsis; Synovitis; Thorax; Vancomycin; Walking
- From:Infection and Chemotherapy 2015;47(2):125-128
- CountryRepublic of Korea
- Language:English
- Abstract: Enterobacter cloacae has emerged as an important nosocomial pathogen, but is rarely a cause of sacroiliitis. Herein, we present the first reported case of Enterobacter cloacae sacroiliitis associated with sepsis and acute respiratory distress syndrome (ARDS). A previously healthy 14-year-old boy presented with low-grade fever and pain in the left side of the hip that was aggravated by walking. Pelvic computed tomography (CT) showed normal findings, and the patient received supportive care for transient synovitis with no antibiotics. However, there was no clinical improvement. On the third day of hospitalization, magnetic resonance imaging of the hip revealed findings compatible with sacroiliitis, for which vancomycin and ceftriaxone were administered. The patient suddenly developed high fever with dyspnea. Chest radiography and CT findings and a PaO2/FiO2 ratio <200 mmHg were suggestive of ARDS; the patient subsequently received ventilatory support and low-dose methylprednisolone infusions. Within one week, defervescence occurred, and the patient was able to breathe on his own. Following the timely recognition of, and therapeutic challenge to, ARDS, and after 6 weeks of parenteral antimicrobial therapy, the patient was discharged in good health with no complications.
