Bacteroides fragilis-Associated Intra-Abdominal Abscess Following Penetrating Trauma
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Abstract
Background: Bacteroides fragilis is a clinically significant anaerobic bacterium known to cause abdominal infections, abscesses, sepsis, and skin and soft tissue infections. We report a case of an intra-abdominal wound infection following a penetrating injury, attributed to B. fragilis.
Methods: Foul-smelling pus from the abdominal wound was collected and sent for anaerobic culture using Robertson’s cooked meat medium. Gram staining and culture were performed on blood agar supplemented with haemin and vitamin K1. The sample's gram stain revealed gram-negative bacilli.
Results: Colony growth was observed on blood agar after 48 hours and was identified as B. fragilis through phenotypic biochemical tests, MALDI-TOF MS, and real-time PCR. The patient was successfully managed with metronidazole.
Conclusion: Prompt diagnosis and early treatment were crucial in reducing the morbidity and mortality associated with this infection.
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9. Marcus G, Levy S, Salhab G, et al. Intra-abdominal infections: the role of anaerobes, enterococci, fungi, and multidrug-resistant organisms. Open Forum Infect Dis 2016; 3(4):ofw232.
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11. Singh S, Goyal V, Padhi P, et al. Bacteroides fragilis endocarditis in a patient with Crohn's disease. BMJ Case Rep 2013; 2013:bcr2013009248.
12. Hadano Y, Iwata H. Septic thrombophlebitis of the superior mesenteric vein with bacteraemia caused by Bacteroides fragilis and Streptococcus intermedius as a complication of diverculitis. BMJ Case Rep 2013; 2013:bcr2013008661.
13. Rodrigues C, Siciliano RF, Zeigler R, et al. Bacteroides fragilis endocarditis: a case report and review of literature. Braz J Infect Dis 2012; 16(1):100-4.
14. Martin T, Aziz H. Bacteroides fragilis: a case study of bacteremia and septic arthritis. Clin Lab Sci 2009; 22(3):131-5.
15. Elgouhari H, Othman M, Gerstein WH. Bacteroides fragilis vertebral osteomyelitis: case report and a review of the literature. South Med J. 2007;100(5):506-11.
16. Ni YH, Wang NC, Peng MY, Bacteroides fragilis bacteremia associated with portal vein and superior mesentery vein thrombosis secondary to antithrombin III and protein C deficiency: a case report. J Microbiol Immunol Infect 2002; 35(4):255-8.
17. Li Y, Shan M, Zhu Z, et al. Application of MALDI-TOF MS to rapid identification of anaerobic bacteria. BMC Infect Dis 2019; 19(1):941.
18. Ramirez MS, Tolmasky ME. Aminoglycoside modifying enzymes. Drug Resist Updat 2010; 13:151-71.
19. Brook I. Microbiology of polymicrobial abscesses and implications for therapy. J Antimicrob Chemother 2002; 50(6):805-10.
2. Yekani M, Baghi HB, Vahed SZ, et al. Tightly controlled response to oxidative stress; an important factor in the tolerance of Bacteroides fragilis. Res Microbiol 2021; 172(2):103798.
3. Goldstein, E. J.. Anaerobic bacteremia. Clin Infect Dis 1996; 23(Suppl. 1):S97-S101.
4. Papaparaskevas J, Mela V, Houhoula DP, et al. Comparative evaluation of conventional and real-time PCR assays for detecting Bacteroides fragilis in clinical samples. J Clin Microbiol 2013; 51(5):1593-5.
5. Patrick S. A tale of two habitats: Bacteroides fragilis, a lethal pathogen and resident in the human gastrointestinal microbiome. Microbiology (Reading) 2022; 168(4).
6. Cohen-Poradosu R, Kasper DL. Mandell, Douglas and Bennett’s principles and practice of infectious diseases. 8th ed. Philadelphia: Elsevier/Saunders; 2015. Anaerobic Infections: General concepts. In: Bennet JE, Dolin R, Blaser MJ eds; pp. 2736–43.
7. Yamanaka Y, Shimabukuro A. Septic abortion presenting as a right lower trapezius abscess secondary to Bacteroides fragilis bacteraemia. BMJ Case Rep 2017; 21:219135.
8. Yildirim H, Balbaba M, Yilmaz T, et al. Endophthalmitis caused by Bacteroides fragilis after pars plana vitrectomy and treatment approach. Asian Pac J Trop Med. 2022; 15:44-6.
9. Marcus G, Levy S, Salhab G, et al. Intra-abdominal infections: the role of anaerobes, enterococci, fungi, and multidrug-resistant organisms. Open Forum Infect Dis 2016; 3(4):ofw232.
10. Ramamurthy D, Pazhani GP, Sarkar A, et al. Case-control study on the role of enterotoxigenic Bacteroides fragilis as a cause of diarrhea among children in Kolkata, India. PLoSOne 2013; 8(4):e60622.
11. Singh S, Goyal V, Padhi P, et al. Bacteroides fragilis endocarditis in a patient with Crohn's disease. BMJ Case Rep 2013; 2013:bcr2013009248.
12. Hadano Y, Iwata H. Septic thrombophlebitis of the superior mesenteric vein with bacteraemia caused by Bacteroides fragilis and Streptococcus intermedius as a complication of diverculitis. BMJ Case Rep 2013; 2013:bcr2013008661.
13. Rodrigues C, Siciliano RF, Zeigler R, et al. Bacteroides fragilis endocarditis: a case report and review of literature. Braz J Infect Dis 2012; 16(1):100-4.
14. Martin T, Aziz H. Bacteroides fragilis: a case study of bacteremia and septic arthritis. Clin Lab Sci 2009; 22(3):131-5.
15. Elgouhari H, Othman M, Gerstein WH. Bacteroides fragilis vertebral osteomyelitis: case report and a review of the literature. South Med J. 2007;100(5):506-11.
16. Ni YH, Wang NC, Peng MY, Bacteroides fragilis bacteremia associated with portal vein and superior mesentery vein thrombosis secondary to antithrombin III and protein C deficiency: a case report. J Microbiol Immunol Infect 2002; 35(4):255-8.
17. Li Y, Shan M, Zhu Z, et al. Application of MALDI-TOF MS to rapid identification of anaerobic bacteria. BMC Infect Dis 2019; 19(1):941.
18. Ramirez MS, Tolmasky ME. Aminoglycoside modifying enzymes. Drug Resist Updat 2010; 13:151-71.
19. Brook I. Microbiology of polymicrobial abscesses and implications for therapy. J Antimicrob Chemother 2002; 50(6):805-10.
| Files | ||
| Issue | Vol 13 No 2 (2025) | |
| Section | Case Reports | |
| DOI | https://doi.org/10.18502/jmb.v13i2.18660 | |
| Keywords | ||
| Anaerobe Bacteroides fragilis Intra-abdominal abscess MALDI-TOF MS Real Time PCR. | ||
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How to Cite
1.
Siddiqui O, William A, Gupta N, Nirmal S, Saxena S, Aggarwal P. Bacteroides fragilis-Associated Intra-Abdominal Abscess Following Penetrating Trauma. J Med Bacteriol. 2025;13(2):79-84.
