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Comment by myrloc | Hacker News Reader

I was just put on 6 weeks of antibiotics (ampicillin and ceftriaxone) for sepsis.

I thought I was coming down with an annual bug (so did the docs). 3 days after going into an urgent care where I was told I was negative for flu and covid, I went to the ER, where they drew blood. All 4 blood cultures returned positive for enterococcus faecalis.

The bacteria is very common in the intestines, but it's not clear (and probably never will be) how it made it into my bloodstream. Their best guess is inflammation in my gut allowing it to "leak" into the blood. This is after CT and ultrasounds of the abdomen.

29 years of no sepsis then.. random sepsis diagnosis!

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Glad you are OK. I am not your internist (/IANAL disclaimer) and I usually don't comment in HN medical threads as weird opinions here, but reading HN taking a break from my work, I'll say generally unless you have some reason like a recent dental procedure to have gotten it depending on your age I'd ask to get a (non urgent) colonoscopy or at least MR enterography or at least consideration of it with a reason why not with someone who knows the particulars of your case and can give you real medical advice.

CT has limited ability to pick up GI malignancy that can lead to translocation of bacteria from colon. If you had something like an autoimmune colitis that lead to translocation you would need to get treated and not all have preceding symptoms.

Thank you for saying this! A loved down was “in the clear” for some stuff. Unfortunately not so clear.

I am also not your internist but wanted to upvote and second this comment. Op mentions being 29 years old, but should have a gi tract evaluation. Not necessarily now when dealing with the bacteremia but should be discussed.

Great ideas, I will ask about these in the follow-up with infection disease.

For sure. I hope it shows nothing and it is a one off but would not want to miss something that needs treatment or predisposes you to recurrence. Take care!

> but it's not clear (and probably never will be) how it made it into my bloodstream.

The term for this is “bacterial translocation”. The intestinal barrier isn’t perfect and some level of bacterial translocation from the GI tract to the bloodstream isn’t abnormal by itself. However, some combination of increased intestinal permeability, reduced immune defense, overgrowth of the bacteria in the GI tract, or mutations of the bacteria can lead to systemic infection.

They probably gave you the “inflammation” explanation because it’s more satisfying than “it happens some times and the potential causes are diverse”.

Glad you’re doing better.

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