Multiple Retroperitoneal Abscesses Caused by Extended-Spectrum β-Lactamase-Producing Escherichia coli: A Case Report

Diagnosis and management of retroperitoneal abscesses caused by ESBL (Extended-Spectrum-β-Lactamase) Escherichia Coli require special attention. A female patient came to the Emergency Department with complaints of abdominal discomfort, bloating, nausea, fever, and urination pain for 1 week, and physical examination demonstrated an enlarged mass in the left flank for the past 6 months. Laboratory results showed an increase in leukocytes and procalcitonin hence the antibiotic cefoperazone sulbactam was given as empirical therapy. An abdominal CT scan revealed multiple retroperitoneal abscesses in the left and right hemiabdomen, therefore levofloxacin and metronidazole were given as additional antibiotics. Percutaneous abscess drainage was performed and from the pus culture obtained grew ESBL Escherichia Coli bacteria. Furthermore, antibiotics were changed to intravenous amikacin according to the results of the susceptibility test. The patient's clinical symptoms improved significantly and she was discharged and evaluated in the outpatient clinic.