Table 1. Reported antibiotic susceptibilities of blood cultures and splenic fluid.

Antibiotic sensitivities showed a variety of antibiotics to which L. rhamnosus should be sensitive. Given the patients clinical response and class sensitivity, piperacillin/tazobacam was provided as an outpatient along with percutaneous perisplenic drainage. Treatment recommendations included antibiotics and drainage for 4-8 weeks, depending on the clearance of infection as seen on CT imaging. At the 4-week interval checkpoint, infection reduction was seen on CT imaging, with concomitant therapy reducing the perisplenic fluid collection from 13.1 cm during hospitalization to 4.9 cm. Based on these sensitivities and imaging findings, a full 8-week treatment course was provided to the patient with piperacillin/tazobacam and drainage. The above reference laboratory MIC breakpoint interpretations were based on Food and Drug Administration or Clinical Laboratory Standards Institute recommendations.

Antibiotic MIC	Sensitivity	Source
Ampicillin MIC=2	Sensitive	Blood, Splenic Fluid
Clindamycin MIC	Sensitive	Blood, Splenic Fluid
Daptomycin MIC	Sensitive	Blood, Splenic Fluid
Erythromycin MIC	Sensitive	Blood, Splenic Fluid
Linezolid MIC=4	Sensitive	Blood
Linezolid MIC=2	Sensitive	Splenic Fluid
Penicillin MIC=2	Sensitive	Blood
Penicillin MIC=1	Sensitive	Splenic Fluid
Vancomycin MIC >16	Resistant	Blood, Splenic Fluid