Abstract Introduction: Community-acquired (CA) carbapenem-susceptible Acinetobacter baumannii (CSAB) enterogenic sepsis is very rare but has a high mortality. Although CA A. baumannii bloodstream infections have been known to develop from respiratory tract, urinary tract, and intravenous device-related infections, CA A. baumannii bloodstream infections from the gastrointestinal tract have not yet been reported. Patient concerns: A 73-year-old male with the chief presentation of gastrointestinal symptoms was initially diagnosed with acute gastroenteritis and showed poor clinical response to empirical antibiotic therapy. Diagnoses: The diagnosis of CSAB enterogenic sepsis was established based on results of blood culture, elevated serum procalcitonin level, and specific hemodynamic changes related to septic shock. Interventions: The patient initially received empirical antibiotic treatment (cefodizime 2.0 q12 hours plus moxifloxacin 0.4 qd); then, treatment was changed to the conventional dose of carbapenem (imipenem 0.5 q6 hour). Outcomes: Finally, CSAB was eliminated from the bloodstream, and the patient was discharged. Lessons: Although severe, CA CSAB enterogenic sepsis is often misdiagnosed because of its clinical rarity. Early diagnosis and appropriate initial empirical antibiotic therapy are crucial for treating such cases.

中文翻译：

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诊断社区获得性碳青霉烯类敏感鲍曼不动杆菌肠源性败血症的挑战

摘要 简介：社区获得性（CA）碳青霉烯类敏感鲍曼不动杆菌（CSAB）肠源性败血症非常罕见，但死亡率很高。尽管已知 CA A. baumannii 血流感染是由呼吸道、泌尿道和静脉装置相关感染引起的，但尚未报道来自胃肠道的 CA A. baumannii 血流感染。患者关注点：一名 73 岁男性，主要表现为胃肠道症状，最初被诊断为急性胃肠炎，对经验性抗生素治疗的临床反应不佳。诊断：CSAB 肠源性败血症的诊断基于血培养结果、血清降钙素原水平升高以及与感染性休克相关的特定血流动力学变化。干预：患者最初接受了经验性抗生素治疗（头孢地嗪 2.0 q12 小时加莫西沙星 0.4 qd）；然后，治疗改为常规剂量的碳青霉烯类（亚胺培南 0.5 q6 小时）。结果：最终，CSAB从血液中清除，患者出院。经验教训：CA CSAB 肠源性败血症虽然很严重，但由于其临床罕见性而经常被误诊。早期诊断和适当的初始经验性抗生素治疗对于治疗此类病例至关重要。CA CSAB 肠源性败血症因其临床罕见性而经常被误诊。早期诊断和适当的初始经验性抗生素治疗对于治疗此类病例至关重要。CA CSAB 肠源性败血症因其临床罕见性而经常被误诊。早期诊断和适当的初始经验性抗生素治疗对于治疗此类病例至关重要。