Two unique presentations of Achromobacter xylosoxidans infections in clinical settings

Vandana Kalwaje Eshwara,Rajath Prakash,Ganesh Pai,Chiranjay Mukhopadhyay,Savitha Mohan

doi:10.3855/jidc.1258

Abstract

Two rare and unique infections of Achromobacter xylosoxidans are described. The first case is a novel presentation of acute necrotising pancreatitis leading to a pancreatic pseudocyst, which was treated successfully in an immunocompetent male. The second case describes a local wound infection of metastatic ductal carcinoma of the breast; the patient consequently succumbed from a pre-existing co-morbid condition. Vigilant and efficient microbiological workup and surveillance are needed to diagnose infections by this rare pathogen in clinical settings.

Highlights

IntroductionAlcaligens xylosoxidance, is a non-fermenting Gram-negative bacillus of low virulence
Achromobacter xylosoxidans, formerly calledAlcaligens xylosoxidance, is a non-fermenting Gram-negative bacillus of low virulence
We present two unique cases: in the first, Achromobacter xylosoxidans caused an infection leading to a pancreatic pseudocyst in an adult immunocompetant man

Summary

Introduction

Alcaligens xylosoxidance, is a non-fermenting Gram-negative bacillus of low virulence. The patient was put on conservative management and meropenem empirically His symptoms did not improve and subsequent ultrasonography findings were suggestive of pancreatic pseudocyst that was supported by Eshwara et al – A. xylosoxidans infections in clinical settings computed tomography (CT) of the abdomen. She had an ulcer on the right chest wall and axilla for seven months, for which she was receiving wound care in the same hospital She was a known case of ductal carcinoma of the right breast diagnosed nine years previously, for which she had undergone a mastectomy followed by chemotherapy and radiotherapy. The wound specimen showed a pure and moderate growth of A. xylosoxidans that was susceptible to amikacin, gentamicin, tobramycin, cefotaxime, ceftazidime, ciprofloxacin, piperacillin, doxycycline, cefoperazone sulbactum, piperacillin tazobactum, and meropenem, but was resistant to ampicillin, cefazolin and cefuroxime. The isolate was thought to be pathogenic locally as the concomitant blood cultures remained sterile

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Discussion

Conclusion