Division of Infectious Diseases

Case of the Month - February 2018

A 19 year old woman presented with abdominal pain, bloody diarrhea, fatigue, and 10 lb. weight loss over 3 weeks. She went to another hospital's emergency room, where she was given a diagnosis of colitis and prescriptions for levofloxacin and metronidazole. Several days later her primary physician told her to also start taking probiotics and referred her to a gastroenterologist. She is a college freshman and lives in the Bronx with her mother, father, grandparents, two sisters, and dog. Her father has a history of ulcerative colitis. She had traveled to Albania during the previous summer. Her family is from Albania, and she likes to eat homemade yogurt, which she makes by boiling milk and adding a small amount of store bought yogurt, which then she leaves to cool, and refrigerates when it reaches room temperature. The milk that she buys is a commercial brand that is pasteurized. 

The following week, she became dehydrated and developed palpitations, and went to the Montefiore E.R. She had a temperature of 36.7oC, heart rate of 158, respiratory rate of 24, and blood pressure of 114/75. She was tired, pale, and had left lower quadrant tenderness. Her labs included wbc 19.6K, hemoglobin 9.6 g/dL, platelets 696K, ESR 96 mm per hour, CRP 10.3, and albumin 2.3 g/dL. One blood culture and one stool culture were obtained. She was given fluids and hospitalized for symptomatic anemia and work up.

Two days after she was admitted to the hospital, bacteria started to grow in the anaerobic bottle of the blood culture. Gram stains are below. What is the organism?
 

Figure 1 Gram stain of broth from the blood culture (100X).
     

 Feb 2018a                  

 
Figure 2 Gram stain of anaerobic growth on blood agar (40X). The arrow points to a typical form.  

   Feb 2018B                                                                                                                               

 

Conferences & Seminars

Infectious Diseases Grand Rounds @ Einstein
Year-End Research Seminar
Drs. Mogollon, Mittal & Ponce
Wednesday, June 27, 2018 @ 8:30 AM

Conference & Seminar Schedules

Click here to log in