Pseudomonas Mendocina Bacteremia: A Case Study and Review of Literature

Abstract

Patient: Male, 64 Final Diagnosis: Pseudomonas mendocina bacteremia Symptoms: Encephalopathy • fever • hypotension • rigors • tachypnea Medication: — Clinical Procedure: — Specialty: Infectious Diseases Objective: Rare disease Background: Pseudomonas mendocina is a Gram-negative, aerobic, rod-shaped bacterium belonging to the family Pseudomonadaceae. In nature, P. mendocina has been isolated from water and soil samples. The species rarely causes disease in humans though severe infections resulting in hospitalization and intensive care have been documented. This case is perhaps the second reported case in the United States of a P. mendocina related infection. In this case report, we analyze the clinical and laboratory features of P. mendocina infection in a severely immunocompromised acquired immunodeficiency syndrome (AIDS) patient and review the available literature. Case Report: A 64-year-old white male with past medical history significant for human immunodeficiency virus (HIV)/AIDS (CD 4 count on admission <10 cells/mm 3 ) diagnosed in 1988 and on antiretroviral therapy since 1992, was admitted to our facility for acute management of a suspected invasive mold infection. On hospital day 20 the patient developed a fever of 39.9°C, had an elevated lactate of 2.6 mmol/L and absolute neutrophil count greater than 1000 cells/mm 3 . On hospital day 22, both blood culture sets were positive for Pseudomonas mendocina . Antibiotic therapy was de-escalated to ceftazidime and after a total treatment course of 10 days the was successfully discharged. Conclusions: There have been 14 reported cases of P. mendocina in the world. Four cases presented with meningitis and 5 with endocarditis. Beyond typical anti-pseudomonal agents, 2 of the reported cases show susceptibility of P. mendocina antibiotics such as sulfamethoxazole/trimethoprim and ceftriaxone. All documented case reports of P. mendocina infection resulted in successful treatment with antibiotics and survival of the patient.

A Systematic Review of Human Infections by Pseudomonas mendocina

“…Hand screening of the included articles' references did not identify any additional studies. Thus, 12 studies met the inclusion criteria of the present study [2,3,[7][8][9][10][11][12][13][14][15][16]. Figure 1 shows a graphical representation of the review process.…”

“…Other less frequent infections by P. mendocina included SSTIs [12,13] in 18.8% (three out of 16 cases), bacteremia (without IE) [10,11] and musculoskeletal infections [14,15] in 12.5% (two cases) each, and peritoneal dialysis-associated peritonitis [16] in 6.3% (one case).…”

Assessment of Bacterial Contamination of Air at the Museum of King John III’s Palace at Wilanow (Warsaw, Poland): Selection of an Optimal Growth Medium for Analyzing Airborne Bacteria Diversity

“…are instead associated with a multitude of mammalian infections [52,53]. Human pathogens can also be found in both genera, including: (i) an opportunistic pathogen P. aeruginosa, which is a common multidrug-resistant bacterium that causes severe infections, especially in patients with cystic fibrosis [54]; (ii) Pseudomonas mendocina, an emerging pathogen that causes mainly nosocomial endocarditis and meningitis [55]; (iii) Staphylococcus aureus and Staphylococcus epidermidis, which are known to cause various skin and soft-tissue infections [56]. Moreover, amongst the detected genera, some can host opportunistic human pathogens, as is the case for the Chryseobacterium genus.…”

Pseudomonas Mendocina Bacteremia in a Hemodialysis Patient With a Central Venous Catheter

“…States 63-year-old man with human immunodeficiency virus/acquired immunodeficiency syndrome with bacteremia [4].…”

“…In 2019, a case of P. mendocina bacteremia was reported in a patient with HIV who presented with fever, elevated lactate, and elevated white blood cell count. This patient was successfully treated with ceftazidime [4]. Another case of bacteremia occurred in a young man with P. mendocina bacteremia that was presumed to have been acquired from his pet bird's drinking water [5].…”