A Case of Septic Pulmonary Embolism Caused by Rhodococcus erythropolis Complicated by Chronic Idiopathic Intestinal Pseudo-obstruction

Abstract

Catheter-related bloodstream infection (CRBSI) is one of the serious complications in patients with chronic idiopathic intestinal pseudo-obstruction (CIPO). Moreover, septic pulmonary embolism (SPE) is a very rare complication in patients on home parenteral nutrition (HPN). Herein, we report a case of CIPO with SPE complicated by CRBSI due to Rhodococcus erythropolis, which is a naturally occurring bacterium.

The patient was a 36-year-old woman with CIPO on HPN. She had a one-month history of continued fever and cough of unknown origin. Chest computed tomography showed multiple nodules in both her lungs, and R. erythropolis was isolated from a peripheral blood culture. She was diagnosed as having CRBSI and SPE. She underwent antibiotic therapy for eight weeks, and her blood culture results became negative. However, the patient repeatedly had a fever with positive blood culture results. We replaced the catheter, after which her fever resolved. Moreover, the multiple lung nodules were further reduced in size.