Escherichia vulneris: an unusual cause of complicated diarrhoea and sepsis in an infant. A case report and review of literature

Abstract

Escherichia vulneris is an opportunistic human pathogen. It has been primarily reported in adult patients and invasive infections have been observed in immune-suppressed individuals. This is the first report of E. vulneris causing complicated diarrhoea and sepsis in an infant. Two month old sick infant, born full-term, was admitted to the paediatrics department with loose motions and refusal to feed for four days. E. vulneris was isolated from blood in pure culture. The isolate was characterized for diarrhoeal virulence markers: heat labile and heat stable toxins (LT, ST) and hemolysin (hlyA) by PCR. The presence of LT enterotoxin and hemolysin provides strong evidence of the diarrhoeagenic potential of E. vulneris, further leading to the invasive infection triggering sepsis. As E. vulneris can lead to serious complications, an attempt should be made in clinical laboratories to identify and further characterize this new Escherichia species.

Keywords: Complicated diarrhoea; Escherichia vulneris; LT toxin; hemolysin (hlyA); infant; sepsis.

Fig. 1

Gel picture showing Escherichia vulneris positive for heat-labile (LT) toxin (508 bp, Lane 1); hlyA toxin (1177bp, Lane 2); and negative for heat-stable (ST) toxin (Lane 3); PCR mixture without the template was taken as a negative control (Lane 4); 100-bp ladder was used as a DNA marker. PCR products were run on 1.8% agarose gel and visualized under UV Transilluminator and pictured using a gel documentation system.