AUTHOR=Gao Hongguang , Li Tian , Feng Li , Zhang Shu 

TITLE=Elizabethkingia miricola Causes Intracranial Infection: A Case Study

JOURNAL=Frontiers in Medicine

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/medicine/articles/10.3389/fmed.2021.761924

DOI=10.3389/fmed.2021.761924

ISSN=2296-858X

ABSTRACT=<p><bold>Background:</bold><italic>Elizabethkingia miricola</italic> is a rarely encountered bacterium in clinical practice. It is a rare gram-negative rod-shaped bacterium associated with lung and urinary tract infections, but never found in cerebrospinal fluid. This paper reports a case of an adult patient infected by <italic>E. miricola</italic> via an unknown route of infection causing a severe intracranial infection. <italic>Elizabethkingia miricola</italic> was detected by culture and Metagenomic next generation sequencing in CSF. Early identification of this strain and treatment with sensitive antibiotics is necessary to reduce morbidity and mortality.</p><p><bold>Case Report:</bold> A 24-year-old male was admitted to a West China Hospital because of headache and vomiting for 2 months. Symptom features included acute onset and long duration of illness. Notably, headache and vomiting were the primary neurological symptoms. Routine cerebrospinal fluid culture failed to identify the bacterium; however, <italic>Elizabethkingia miricola</italic> bacterium was detected via second-generation sequencing techniques. <italic>Elizabethkingia miricola</italic> was found to be a multi-drug resistant organism, hence, treatment with ceftriaxone, a commonly used drug for intracranial infections was ineffective. This strain eventually caused severe intracranial infection resulting in the death of the patient.</p><p><bold>Conclusion:</bold> In summary, this study comprehensively describes a case of an adult patient infected by <italic>E. miricola</italic> and discusses its early identification as well as application of sensitive antibiotics in the emergency setting.</p>