A 27-year-old HIV-1 positive male was admitted in September 2018 for sudden onset of vomiting and diarrhea and was conservatively managed for positive Norovirus on a Gastrointestinal PCR panel. It was anticipated to start him on ibalizumab intravenous infusions and enfuvirtide upon discharge and a PICC line was placed in the right internal jugular vein.
On the third day of line placement, he developed a fever with mild respiratory symptoms. His respiratory PCR panel for Rhino/Enterovirus was positive and blood cultures grew Enterobacter. Blood cultures from PICC line confirmed the diagnosis of central line-associated infection and the line was discontinued. He was started on meropenem, given sensitivities of the cultures. However, despite initial improvement, patient spiked fever again two days later. The second blood cultures turned out to be positive for Bordetella bronchiseptica, prompting to continue the patient on meropenem for further 2 weeks and thereafter the infection resolved uneventfully.