Members of the Erwiniaceae family, which can be found saprophytic in humans, have been identified several times as an infectious agent after their first identification in 1920. Erwinia persicina was first identified as a plant pathogen by being isolated from cucumber, tomato and banana in 1990, and it was shown to cause disease in many plant species in the following years. E.persicina was diagnosed as a urinary tract infection agent in an 88-year-old female patient in 1998. Our case, a 30-year-old male patient, was hospitalized for perihilar cholangiocarcinoma while being examined with the complaint of abdominal pain. In preparation for the operation, external drainage from the left lobe biliary tract was performed. The same bacterial growth was detected in the three bile fluid cultures of the patient taken on different dates. The bacterium was identified as E.persicina by MALDI-TOF Microflex LT/SH Smart MS (Bruker Daltonics, Germany) and Erwinia rhapontici with VITEK MS (Biomerieux, France), Rahnella aquatilis with VITEK 2 automated system, Pantoea agglomerans with BD Phoenix™ M50 (BD Diagnostics, USA) automated system. E.persicina identification was also obtained by Sanger sequencing. Antibiotic susceptibility results were evaluated according to the non-species related breakpoints criteria of the European Committee on Antimicrobial Susceptibility Testing (EUCAST). While resistance was found to cefuroxime and cefazolin, the isolate was found to be sensitive to many other beta-lactam antibiotics, quinolones and aminoglycosides. E.persicina is a bacterium that is rarely isolated as an infectious agent in humans. The reason for this may be that it is a plant pathogen on the one hand, and mistakes made in its diagnosis on the other. Many identification systems do not have this bacterium in their library. In this case report, our aim was to emphasize that mistakes made in the diagnosis of E.persicina may play a role in the rare occurence of the agent.

Background: Early treatment of severe acute hepatitis B virus (HBV) infection with nucleos(t)ide analogues may prevent progression to acute liver failure (ALF). Patients and methods: The charts of 24 patients who were treated for severe acute HBV infection (either INR ≥ 1.5 or INR≥ 1.4 and total bilirubin ≥ 20 mg/dL at the referring institution or after admission) between April 2021 and May 2023 (inclusive) were evaluated retrospectively. Twelve patients were women; median [range] age: 48 [35–68]. Entecavir (0.5 mg/day) (n = 16) or tenofovir disoproxil fumarate (245 mg/day) (n =8) were used depending on availability. Results: Two patients required liver transplant which was performed successfully in one (no suitable donor for the other). Deterioration to ALF was prevented in 22 of the 24 cases (92%); these patients could be discharged after median (range) 12 (5–24) days following initiation of the antiviral drug. There was no significant difference in efficacy between the two antiviral agents. The anti-HBsAg antibody became positive in 16 patients (73%); one other patient became HBsAg negative at 1 month after discharge but was lost to follow up. Five patients (23%) are still HBsAg positive but all except one have started treatment in the last 6 months. One of the recently treated 4 patients stopped taking the antiviral drug at his own will and one has become anti-HIV antibody positive during follow up. Conclusion: Early treatment of severe acute HBV infection with entecavir or tenofovir disoproxil fumarate prevents the need for liver transplant and consideration of living donors.