Facklamia hominis bacteremia after transurethral resection of the prostate: a case report
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CASE REPORT
Facklamia hominis bacteremia after transurethral resection of the prostate: a case report Miriam Gahl1, Thomas Stöckli2 and René Fahrner1*
Abstract Background: Transurethral resection of the prostate (TUR-P) is one of the most frequent routine procedures in urology. Because of the semisterile environment, postoperative infections, including sepsis, are a common complication, with Escherichia coli, Klebsiella spp., Proteus mirabilis or Enterococcus faecalis as frequently isolated pathogens. Facklamia hominis is a gram-positive, facultatively anaerobic, alpha-hemolytic, catalase-negative coccus that was first described in 1997. To date, only a few cases of infectious complications have been described. We report the first case of postoperative bacteremia due to Facklamia hominis after TUR-P. Case presentation: An 82-year-old man developed fever only a few hours after elective TUR-P because of benign prostate syndrome. After cultivation of blood cultures, antibiotic therapy with ceftriaxone was intravenously administered and changed to oral cotrimoxazole before discharge of the afebrile patient. One anaerobic blood culture revealed Facklamia hominis. Under antibiotic therapy, the patient remained afebrile and showed no signs of infections during follow-up. Conclusions: Fever and bacteremia are frequent complications after TUR-P. This study is the first report of Facklamia hominis in a postoperative blood culture after TUR-P. To date, there are only a few reports of patients with infectious complications and isolation of Facklamia hominis in various patient samples. Because Facklamia hominis resembles viridans streptococci on blood agar analysis, this pathogen may often be misidentified. In this case identification of Facklamia hominis was possible with matrix-assisted laser desorption/ionization time-of-flight mass spectrometry. It has been postulated that Facklamia hominis might be a facultative pathogen and that its incidence will increase in the future. Keywords: Bacteremia, Facklamia hominis, Transurethral resection of the prostate, Genital flora Background Transurethral resection of the prostate (TUR-P) is one of the most frequent routine procedures in urology. Because of the semisterile environment and continuous rinsing with water, postoperative infections, including sepsis, are a common complication [1, 2]. Despite this *Correspondence: [email protected] 1 Department of General, Visceral and Thoracic Surgery, Bürgerspital Solothurn, Schöngrünstrasse 42, 4500 Solothurn, Switzerland Full list of author information is available at the end of the article
fact, prophylactic antibiotics are still controversial, and applied substances vary in regard to the local spectrum of bacteria [1–4]. As a sign of procedural bacteremia, postoperative fever is often encountered early after surgical intervention. The most frequently isolated pathogens are Escherichia coli, Klebsiella spp., Proteus mirabilis and Enterococcus faecalis, which are also often detected during simple cystitis [5]. To cover th
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