{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T17:27:57Z","timestamp":1788456477532,"version":"build-2803163510"},"reference-count":15,"publisher":"BMJ","issue":"12","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,11,9]]},"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:p>We present a case of recurrent cholangitis caused by <jats:italic>Shewanella algae<\/jats:italic>, a lethal, emerging pathogen that clinicians should be made aware of. An 86-year-old man with a history of gastrectomy for peptic ulcer disease and a cerebrovascular accident with known choledocholithiasis presented with recurrent episodes of cholangitis that failed conservative antibiotic treatment regimens. <jats:italic>Shewanella<\/jats:italic> has been described to have increasing resistance to piperacillin and tazobactam. Both <jats:italic>S. algae<\/jats:italic> and multidrug-resistant <jats:italic>Escherichia coli<\/jats:italic> were co-isolated in this patient, which required broader spectrum antibiotics for successful treatment and management. A high index of suspicion is required if the history is suggestive of marine or aquatic exposure, which could expose the patient to this lethal pathogen. Re-thinking and re-taking the history are important cornerstones in refining the diagnosis when faced with recurrent presentations of the same problem.<\/jats:p>","DOI":"10.1136\/bcr-2020-237655","type":"journal-article","created":{"date-parts":[[2020,12,10]],"date-time":"2020-12-10T14:16:14Z","timestamp":1607609774000},"page":"e237655","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["<i>Shewanella<\/i>: an important, emerging and lethal pathogen in a patient with recurrent presentations of cholangitis"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0514-3532","authenticated-orcid":false,"given":"Jason","family":"Hong","sequence":"first","affiliation":[{"name":"Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Victoria, Australia"},{"name":"Department of General Surgery, Box Hill Hospital, Box Hill, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Steen","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Box Hill Hospital, Box Hill, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2983-4768","authenticated-orcid":false,"given":"Enoch","family":"Wong","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Box Hill Hospital, Box Hill, Victoria, Australia"},{"name":"Monash University Eastern Health Clinical School, Box Hill Hospital, Box Hill, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ben","family":"Keong","sequence":"additional","affiliation":[{"name":"Department of General Surgery, Box Hill Hospital, Box Hill, Victoria, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2020,12,10]]},"reference":[{"key":"2025082713230510000_13.12.e237655.1","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/19.2.279"},{"key":"2025082713230510000_13.12.e237655.2","doi-asserted-by":"publisher","DOI":"10.1007\/s00534-006-1152-y"},{"key":"2025082713230510000_13.12.e237655.3","unstructured":"Winn W , Allen S , Janda W , et al . 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