P0787 - A Rare Case of Moraxella osloensis Bacteremia in a Patient With Decompensated Cirrhosis

Farah Harmouch, MD¹, Brittney Shupp, DO¹, Kashyap Shah, DO¹, Hammad Liaquat, MD¹, Ayaz Matin, MD², Kimberly Chaput, DO^3
1St. Luke's University Health Network, Bethlehem, PA; ²St. Luke's University Hospital, Bethlehem, PA; ³St. Luke's University Health Network, Fountain Hill, PA

Introduction: Moraxella osloensis is a gram-negative coccobacillus that can be isolated from normal flora of the respiratory tract. It is a rare human pathogen and typically infects immunocompromised individuals such as cancer patients and organ transplant recipients. We present a rare case of a cirrhotic patient presenting with alcoholic hepatitis and Moraxella osloensis bacteremia

Case Description/Methods: A 56 year old female with a past medical history significant for alcoholic cirrhosis complicated by ascites, hepatic encephalopathy, nonbleeding esophageal varices, and thrombocytopenia presented to ED with nausea, vomiting, abdominal pain, and diarrhea for approximately 1 week. She was unable to tolerate oral intake and was having 7-8 loose bowel movements per day. Her symptoms started after an episode of binge drinking. On admission, vital signs revealed a temp 100.1 F, HR 108, RR 16, and spO2 98%. Labs were significant for AST 275, ALT 82, Alk Phos 261, total bilirubin 7.93, and Albumin 3.3. CBC revealed WBC 3.00, hgb 9.5, and PLT 26. Sepsis was suspected and she was given 2.5 L of IV fluids and started on broad spectrum antibiotics. Maddrey’s DF score was 33.7. She was started on trental 400 mg TID due to alcoholic hepatitis. CT abd/pelvis with IV contrast revealed mild wall thickening affecting the colon possibly suggesting colitis with no evidence of bowel obstruction or perforation. Blood cultures were drawn and later grew Moraxella osloensis. She was transitioned to ceftriaxone and then cefdinir to complete a 7-day course of antibiotics. Patient was seen 2 weeks later in our office and showed complete clinical recovery.

Discussion: To our knowledge, only one prior case of Moraxella osloensis has been described in a cirrhotic patient without known malignancy. Moraxella osloensis infection lead to peritonitis without known bacteremia in the past case. Our case is unique in that the Moraxella bacteremia was diagnosed and the likely source of bacteremia was gastrointestinal infection and translocation from the gut and into the bloodstream from persistent diarrhea in the setting of immunocompromised state due to cirrhosis.


Disclosures:
Farah Harmouch indicated no relevant financial relationships.
Brittney Shupp indicated no relevant financial relationships.
Kashyap Shah indicated no relevant financial relationships.
Hammad Liaquat indicated no relevant financial relationships.
Ayaz Matin indicated no relevant financial relationships.
Kimberly Chaput indicated no relevant financial relationships.


Farah Harmouch, MD¹, Brittney Shupp, DO¹, Kashyap Shah, DO¹, Hammad Liaquat, MD¹, Ayaz Matin, MD², Kimberly Chaput, DO³. P0787 - A Rare Case of Moraxella osloensis Bacteremia in a Patient With Decompensated Cirrhosis, ACG 2021 Annual Scientific Meeting Abstracts. Las Vegas, Nevada: American College of Gastroenterology.