Korean J Pancreas Biliary Tract.  2023 Apr;28(2):43-47. 10.15279/kpba.2023.28.2.43.

Acute Cholangitis with Common Bile Duct Stone Caused by Lactococcus garvieae: A Case Report

• Lee JS
• Han J
• Jeong HT
• Bae JH
• Kim HG
• Kwon HH

• KMID: 2541912
• DOI: http://doi.org/10.15279/kpba.2023.28.2.43

Abstract

Lactococcus garvieae is a Gram-positive cocci that has been known to be a fish pathogen, and considered as a low virulence organism rarely associated with human infection. We report a case of acute cholangitis with common bile duct (CBD) stone and bacteremia by L. garvieae bacteremia in a 70-year-old male. The patient presented with epigastric pain and was diagnosed with two CBD stones. Blood culture obtained prior to empiric antimicrobial therapy with ceftizoxime sodium showed growth with Escherichia coli and L. garvieae. The bacteria were confirmed by matrix-assisted desorption/ionization time-of-flight mass spectrometry. Initial attempt at endoscopic biliary drainage failed, and the patient underwent percutaneous transhepatic biliary drainage and subsequent stone removal. He occasionally ingested raw fish and had a history of gastric ulcer with acid suppression therapy, which could be possible risk factors for L. garvieae infection. This is the first case of L. garvieae bacteremia in acute cholangitis.

Keyword

Lactococcus garvieae; Cholangitis; Choledocholithiasis; Bacteremia; 락토코커스 가비에; 담관염; 총담관석; 균혈증