Cronobacter Sakazakii Bacteremia in a 76-year-old Woman: A Case Report

Cronobacter sakazakii, commonly found in contaminated infant formula and thereby causes infantile bacteremia, is rarely associated with adult bacteremia. We present the tenth case of C. sakazakii bacteremia in adults. The patient is a 76-year-old woman who resides in a skilled nursing facility and presents with risk factors including bullous pemphigoid, Type II diabetes mellitus, hypertension, hyperlipidemia, chronic kidney disease, and anemia. The therapy was started with intravenous ciprofloxacin and vancomycinempirically. After consultation with an Infectious Diseases specialist, ciprofloxacin and vancomycin was replaced with meropenem based on the patient’s extensive bullous lesions, history of ESBL infections, and possible pneumonia. Later, the therapy was de-escalated to intravenous ceftriaxone and vancomycin after culture and sensitivity testing were available and clinical signs of improvements were evident. She was sent back to her skilled nursing but was re-admitted 10-days later. She was placed on dialysis for altered mental status secondary to acute renal failure. Blood and urine cultures were repeated and had no evidence of bacterial growth.