From Bedsores to Bloodstream: A Rare Case of Elizabethkingia meningoseptica-Induced Sepsis.

Elizabethkingia meningoseptica (E. meningoseptica) is an emerging multidrug-resistant nosocomial pathogen that primarily affects debilitated and immunocompromised individuals. We report a rare case of E. meningoseptica-associated sepsis arising from chronic bilateral gluteal pressure ulcers in a 64-year-old bedridden male patient with diabetes mellitus, hypertension, and recurrent cerebrovascular accidents, highlighting the importance of considering uncommon pathogens in non-healing wounds. An initial wound culture yielded Proteus mirabilis, and the patient was started on intravenous meropenem. Despite therapy, there was no clinical improvement, with persistent wound discharge and progressive tissue necrosis. Repeat wound and blood cultures subsequently grew E. meningoseptica, which was identified using the VITEK 2 automated system (bioMérieux, Marcy-l'Étoile, France). Antimicrobial susceptibility testing performed using the VITEK 2 system demonstrated susceptibility to piperacillin-tazobactam, cefoperazone-sulbactam, ciprofloxacin, and cotrimoxazole, with resistance to carbapenems and aminoglycosides. Meropenem was discontinued, and targeted therapy with piperacillin-tazobactam was initiated. Significant clinical improvement was observed within five to seven days, with marked reduction in wound discharge and local inflammatory signs and progressive wound granulation by day 14. This case highlights the importance of repeat cultures, accurate microbiological identification, and close laboratory-clinician communication in patients with non-healing chronic wounds who fail to respond to empirical therapy.