First Report of Sphingobacterium multivorum causing a spontaneous bacterial peritonitis in a cirrhotic patient in Tunisia: A case report

Background: Sphingobacterium is an aerobic, glucose non-fermenting, Gram-negative rod bacterium that has been isolated from soil, plants, food, and water sources, including in hospitals. Reports of systemic infections caused by Sphingobacterium multivorum (S. multivorum) are rare, and their clinical and microbiological characteristics remain unclear. We report the first case of spontaneous bacterial peritonitis caused by S. multivorum in a cirrhotic patient in Tunisia. Case report: A 67-year-old woman with hypertension and with chronic obstructive pulmonary disease was admitted for the management of grade 3 hepatic encephalopathy. Abdominal CT was also obtained at presentation, which showed a small, nodular-appearing liver compatible with cirrhosis with a large volume of ascites. The only isolate from the peritoneal fluid culture was S. multivorum. Based on the antibiotic susceptibility results of the isolates, cefotaxim was administered intravenously for 14 days, with good therapeutic outcomes. Conclusions: S. multivorum infection is rare, and its microbiology and pathogenicity in humans is mostly unknown. Therefore, multiple diagnostic approaches should be used to identify S. multivorum, and antimicrobial therapy should be selected based on the in vitro susceptibility. This report provides clinicians with novel information on the clinical manifestations and diagnostic methods for an accurate diagnosis of S. multivorum.