This case report highlights that E. anophelis may indeed cause significant infection and should not be considered a contaminant especially in immunosuppressed individuals. The organism originates from water sources and may be introduced into the hospital environment from an outside source.

Emphasis on educating family members, close nursing monitoring, and reporting of suspected, unsupervised manipulation of medical equipment should be considered to prevent contamination by this organism from outside sources.

A 67-year-old woman with a past history of hip osteoarthritis, dyslipidemia, and recent cholecystectomy presented to the hospital with abdominal pain.

Admission blood work showed leukocytosis with white blood cell count of 13.0 × 109/L, elevated creatinine of 180 µmol/L, normal lipase, and cholestatic pattern of abnormal liver enzymes with transiently elevated alanine transaminase and aspartate transaminase both > 2–3x upper limit of normal, and alkaline phosphatase and gamma-glutamyl transferase both persistently > 1000 U/L.

Computerized tomography (CT) of the abdomen revealed peripancreatic, perinephric, and periureteric stranding without any stones or well-defined fluid collections.

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