Case of the Month - January 2020
A 32 year old man with a history of AIDS and non-compliance with antiretroviral treatment presented with several days of abdominal pain. The pain was constant, diffuse, and accompanied by abdominal distension. He also reported a one week bout of diarrhea that had occurred several months previously but had resolved.
He had no history of hepatitis, alcoholism, or other liver disease.
Phyical examination was notable for fever of 102.0oF and abdominal distension with a fluid wave. A CT scan of the abdomen showed a large amount of abdominopelvic ascites. His viral load was 119,540 copies/ml and CD4 count was 105 cells/µl. The ascitic fluid had 570 wbc and 10K rbc, with an albumin of 1.9 and a glucose of 55 (serum glucose 79). No organisms were seen on Gram, Kinyoun, or Calcofluor stains, and flow cytometry of the ascitic fluid revealed plasma cells positive for CD30, CD138, EMA, MUM1, CD45 and HHV8, favoring primary effusion lymphoma. Quantiferon testing was negative.
Blood cultures drawn at the time of initial presentation were positive and upon subculture, the organism shown below was recovered. The organism was a lactose non-fermenter, oxidase-negative, and not motile. Name the bacteria.
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Growth on blood agar
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Growth on MacConkey agar