The patient was a 12-month-old girl with a history of NARTI and Apple Peel syndrome, operated on three occasions due to intestinal obstruction during the newborn period.
He underwent intestinal resection leaving 29 cm of small intestine and ileocecal valve.
The patient was treated with PN through a Broviac CVC and low volume AEC as enteral stimulation by gastrostomy with jejunal tube.
During the first months of life she presented intercurrent infectious conditions: a catheter-associated infection by oxacillin-resistant Staphylococcus aureus, treated with vancomycin for 14 days; diarrhea by enteropathogenic Escherichia coli (ECVEP) and viral etiology.
At one year of life, the patient presented with diarrhoea, fever, decay and intolerance to SCA. The tests requested were suggestive of bacterial infection with a CRP of 93 mg/lt (VN) < 10 mg/mm neutrophilia.
The coprocultive was positive for ECEP, with fecal leukocytes (LF) negative and RTV (-), so treatment with neomycin was indicated.
The patient had a positive urine culture for Klebsiella pneumoniae, with a urine sediment that did not suggest infection, but because the patient remained febrile, it was decided to prescribe cefoxime; the repeated urocultiva was negative.
Due to persistent fever curve vancomycin was associated.
Two peripheral hemocultives taken at the beginning of the clinical picture were informed positive to a Gram-positive cocci in study, possible Streptococcus, with resistance to vancomycin and cefoxime, according to the NCCLS tables for Streptococcus no.
The strain was sent to the ISP, a national reference laboratory, for identification.
The quantitative blood culture taken by catheter was reported as negative.
During the course of fever, the Broviac catheter was fractured and replaced by a new one, and the jejunostomy tube was changed when the former was displaced.
The stools remained altered, with abdominal distension and intolerance to the resumption of CEA; with suspicion of abdominal infection metronidazole was added.
From then on the fever curve and stool frequency decreased, improving laboratory parameters.
He completed 14 days of treatment with vancomycin, cefoxime and 7 days of metronidazole, with good evolution.
Subsequently, the report of the ISP that identified the strain sent for study as Leuconostoc sp.
SSI was confirmed according to the microbiological characteristics of the strain, and as part of a research protocol, amplification and automatic sequencing of the 16S rRNA fragment was performed.
The sequences obtained were analyzed and recognized in the GeneBank database as Leuconostoc garlicum.
In subsequent infectious cases, this agent was not isolated again.
