Presumed Bergeyella zoohelcum Bacteremia of Uncertain Source in a Patient With Cirrhosis and Concurrent Lower-Extremity Cellulitis

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We report presumed Bergeyella zoohelcum bacteremia in a man in his early 70s with primary sclerosing cholangitis (PSC)-associated cirrhosis, prior transjugular intrahepatic portosystemic shunt (TIPS) placement, ulcerative colitis, and Parkinson disease.He presented after a ground-level fall and was concurrently found to have left lower-extremity cellulitis.Gram-negative rods were recovered from the aerobic bottles of two independently collected peripheral blood-culture sets and were reported by the clinical microbiology laboratory as consistent with B. zoohelcum.The specific species-identification method could not be retrieved, and repeat blood cultures showed no growth.The patient had seven household cats but reported no recent animal bite or scratch.Although the cellulitis was considered a possible site of entry, the wound culture yielded mixed organisms without establishing B. zoohelcum at the skin site, and the source of bacteremia remained unconfirmed.He completed a 10-day course of ceftriaxone 2 g intravenously once daily with clinical improvement and persistently negative repeat blood cultures.This case highlights the importance of matching diagnostic certainty to the available microbiologic evidence and distinguishing epidemiologic exposure from a microbiologically confirmed source of infection.