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CC BY-NC-ND 4.0 · J Lab Physicians 2020; 12(03): 222-224
DOI: 10.1055/s-0040-1721162
Case Report

Leclercia adecarboxylata Causing Spontaneous Bacterial Peritonitis in a Child with Nephrotic Syndrome: A Case Report and Review of Literature

Ijas Hassan
1   Division of Pediatric Nephrology, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
,
Parakriti Gupta
2   Department of Microbiology, Research Block-A, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
,
Pallab Ray
2   Department of Microbiology, Research Block-A, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
,
Karalanglin Tiewsoh 
1   Division of Pediatric Nephrology, Department of Pediatrics, Advanced Pediatrics Centre, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Abstract

Infection is an important complication of childhood nephrotic syndrome (NS) and spontaneous bacterial peritonitis (SBP) is a frequently encountered one. We present a 7-year-old boy with NS who had decreased urine output, generalized body swelling, and abdominal pain. Urine analysis showed proteinuria of 50 mg/m2/d. Ascitic tap showed total leukocyte count of 100 cells/mm3, sugar of 67 mg/dL, and protein of 1.1 g/dL. Gram stain revealed gram-negative bacilli with pus cells and culture grown Leclercia adecarboxylata (LAD). LAD was identified using matrix-assisted laser desorption ionization-time of flight mass spectrometry (MALDI-TOF MS) with an identification score of 2.0. The organism showed good susceptibility to common antibiotics. The boy had no direct contact with livestock and the source of infection remains speculative. Devitalized skin because of massive edema seems to be the most plausible site of entry for the organism. Our patient was started on ceftriaxone and improved. LAD is a rare opportunistic pathogen, which belongs to Enterobacteriaceae and usually causes soft tissue infections. As far as we know, this is the first case where it has caused peritonitis in a child with NS. We also reviewed other pediatric cases.

Keywords

Leclercia adecarboxylata - nephrotic syndrome - spontaneous bacterial peritonitis


Publication History

Article published online:
23 November 2020

© 2020. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/.)

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