Community-acquired Achromobacter xylosoxidans infection presenting as a cavitary lung disease in an immunocompetent patient

Abstract

Achromobacter xylosoxidans is a gram-negative bacterium that can oxidize xylose. It is commonly found in contaminated soil and water but does not normally infect immunocompetent humans. We report a case of a cavitary lung lesion associated with community-acquired A. xylosoxidans infection, which mimicked pulmonary tuberculosis or lung cancer in an immunocompetent man. The patient was hospitalized due to hemoptysis, and chest computed tomography (CT) revealed a cavitary lesion in the superior segment of the left lower lobe. We performed bronchoscopy and bronchial washing, and subsequent bacterial cultures excluded pulmonary tuberculosis and identified A. xylosoxidans. We performed antibiotic sensitivity testing and treated the patient with a 6-week course of amoxicillin/clavulanate. After 2 months, follow-up chest CT revealed complete resolution of the cavitary lesion.

Nosocomial Achromobacter xylosoxidans Infection Presenting as a Cavitary Lung Lesion in a Lung Cancer Patient

“…[ 12 ]. We were able to find only one case during our literature search, in which this bacteria presented as a cavitary lung lesion [ 11 ]. However, this presentation is different from our case in that it stemmed from a community-acquired infection in an otherwise healthy immunocompetent man who had no significant past medical history or recent hospitalizations [ 11 ].…”

“…Cavitary lung lesions caused by A. xylosoxidans are extremely rare in the medical literature [11]. The case report we found in the literature was a middle-aged immunocompetent man who had a community-acquired A. xylosoxidans induced cavitary lung lesion that responded to antibiotics [11]. However, to the best of our knowledge, there are no reports in the literature of A. xylosoxidans associated cavitary lung lesions in lung cancer patients.…”

“…The most commonly reported infectious etiologies include pulmonary tuberculosis (TB), common bacteria such as Staphylococcus Aureus, and fungi such as aspergillosis [9,10]. Cavitary lung lesions caused by A. xylosoxidans are extremely rare in the medical literature [11]. The case report we found in the literature was a middle-aged immunocompetent man who had a community-acquired A. xylosoxidans induced cavitary lung lesion that responded to antibiotics [11].…”