An unusual presentation of acute gastroenteritis caused by elizabethkingia meningoseptica in a child with sepsis from rural karnataka-a case report

Elizabethkingia meningoseptica, a Gram negative obligate aerobic bacilli, though widely distributed in nature (water, soil, salt water ) it does not form a part of normal human flora .Elizabethkingia meningoseptica has been reported to cause meningitis in premature and new born infants. We report a case of acute gastroenteritis caused by this organism in a child with sepsis. A 1 month 23 days old infant was referred to the Paediatric Unit of Kasturba hospital, Manipal presenting with complaints of high grade fever of 10 days duration and loose stools since 8 days .Routine Laboratory examinations were performed. Microbiological investigations were processed by standard techniques. Peripheral smear report showed leukocytosis and platelet count appeared low normal. Using biochemical tests and VITEK 2C (Biomerieux) Identification system , Elizabethkingia meningoseptica was identified as the sole pathogen which was confirmed by its repeated isolation from three consecutive stool samples. Blood and urine cultures were sterile after 24 and 36 hours of incubation respectively. The infant's diarrhoea resolved with treatment. To our knowledge and from literature review ,this is the first case of diarrhoea caused by Elizabethkingia meningoseptica from an infant, being reported from South India-Manipal, Karnataka. The genus Elizabethkingia belongs to the family Flavobacteriaceae of the Class Flavobacteria and order Flavobacteriales. This organism is usually multiresistant to antibiotics typically prescribed for treating gram-negative bacterial infections, but often susceptible to agents generally used for treating gram positive bacterial infections . This bacterium has been associated with cases of neonatal meningitis and septicaemia, and nosocomial pneumonia, endocarditis, and postoperative bacterimia in immunocompromised individuals. The present child with Elizabethkingia meningoseptica infection seems to be the first case to be reported with diarrhoea due to this organism. The patient recovered from diarrhoea after treatment with appropriate antibiotics.