Table 2 Summary of the clinical case
From: Streptococcus cristatus bacteremia in a patient with poor oral hygiene: a case report
Day | Signs and symptoms | Remarkable labs | Diagnostic tests | Therapeutic interventions |
|---|---|---|---|---|
1 | Fatigue Confusion Denies constitutional symptoms Denies melena or hemoptysis | ·Complete blood count: Hgb 7.0 g/dL, PLT 94,000 per microliter, WBC 4.8 × 109/L ·Liver profile: TBil 3.3 mg/dL, DBil 1.3 mg/dL, ALP 323 IU/L, AST 21 U/L, ALT 8 U/L ·Ammonia: 106 µ/dL ·Urinalysis: Clear ·COVID-19 PCR: Not detected | ·CT head: No acute processes · Chest X-ray: No acute process ·Blood culture: Streptococcus cristatus × 2 ·Peritoneal culture: no growth | ·Therapeutic/diagnostic paracentesis ·Started on lactulose and rifaximin ·Started on octreotide, pantoprazole, and ceftriaxone |
2 | Fatigue and confusion improved Denies constitutional symptoms Denies melena or hemoptysis | ·Hgb 5.9 g/dL pretransfusion ·Hbg 6.9 g/dL post-transfusion | ·EGD: no overt signs of bleeding; diffuse and friable portal hypertensive gastropathy | ·Ceftriaxone continued for treatment of S. cristatus bacteremia ·1 unit of pRBCs ·Octreotide discontinued |
3 | No complaints Denies melena or hemoptysis | ·Hgb: 6.4 g/dL pretransfusion ·Hbg 8.6 g/dL post-transfusion | ·TTE: New mild-to-moderate aortic regurgitation but no other evidence of infective endocarditis | ·1 unit of pRBCs |
6 | No complaints | ·Hgb 8.3 g/dL | ·TEE: similar findings to TTE | |
8 | Discharged | ·Hgb 8.6 g/dL | ·Switched to oral cefpodoxime 200 mg |