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Primary peritonitis caused by Raoultella ornithinolytica in a 53‐year‐old man
Abstract
Introduction:
Raoultella ornithinolytica is a Gram‐negative bacillus. This bacillus was until recently often confused with Klebsiella spp. It is known primarily for causing histamine fish poisoning or scombroid syndrome, and rarely causes human infections. This case report discusses a patient who presented with generalized primary peritonitis due to R. ornithinolytica.
Case presentation:
A 53‐year‐old Scandinavian man resident in Botswana, sub‐Saharan Africa, presented to the emergency department shortly after onset of lower abdominal pain and dysuria. He was treated for urinary tract infection and discharged. He came back after 16 h with more severe, generalized abdominal pain and a fever of 38 °C. Abdominal sonography was unremarkable. Examination confirmed peritonitis, particularly marked in the right iliac fossa. He had mild leukocytosis 13.1×109 l−1, a C‐reactive protein level of 372.7 mg l−1 and his serum albumin level was 31 g l−1. He was admitted for parenteral antibiotics, laparoscopic peritoneal lavage and appendectomy. He had 500 ml of free pus in the abdomen with no evident focal source. A pus swab grew R. ornithinolytica. The pathology showed mild early acute appendicitis with severe periappendicitis and suppurative peritonitis. He was discharged home after 7 days of parenteral antibiotics.
Conclusion:
R. ornithinolytica infections are rare in humans, but they can be life‐threatening.
- Received:
- Accepted:
- Published Online:
Keyword(s):
appendicitis
,
infections
,
laparoscopy
,
primary peritonitis
and
Raoultella ornithinolytica
© 2014 The Authors