Sphingomonas paucimobilis - a rare cause of splenic abscesses

Abstract

Rationale: Infections with Sphingomonas paucimobilis are rarely described in the literature and can be community-acquired or associated with healthcare, especially in patients with chronic conditions (e.g., diabetes mellitus), malignancies, or other causes of immunosuppression, except in people without comorbidities. We present the case of a patient with diabetes mellitus and hypertension diagnosed during a routine evaluation, with splenic abscess caused by S paucimobilis . Our literature search revealed no other case report of splenic abscess caused only by S paucimobilis . Patient concerns: We present the case of a 55-year-old Caucasian man with type 2 diabetes mellitus and hypertension. Diagnosis: Thoraco-abdominal computed tomography revealed splenomegaly of 20X16X18 cm, with a homogeneous subcapsular hypodense collection, with a mass effect on the left hemidiaphragm. Interventions: The patient underwent surgical intervention and S paucimobilis was isolated on blood agar. Outcome: The patient received treatment with ciprofloxacin (500 mg twice daily) for 14 days, with favorable outcomes. Lessons: S paucimobilis , a low-virulence bacterium, can cause community-acquired or nosocomial infections. Visceral localizations, usually symptomatic, can evolve rapidly, and the diagnosis is associated with complications or, as in our case, with careful investigation of some changes in laboratory investigations.

Multiple hepatosplenic abscesses in an immunocompetent host

“…It is flagellated, unsporulated, and yellow-pigmented. 2 It is considered less virulent because of the presence of glycosphingolipid in its membrane instead of lipopolysaccharide A which is usually found in gram-negative organisms. The monokine production induced by lipopolysaccharide A is much stronger than that of glycosphingolipid, thus a less severe inflammatory response with S. paucimobilis.…”

“…11 S. paucimobilis is omnipresent in the environment and can infect patients in hospitals via contaminated distilled water, sterile drug solutions, hemodialysis fluids, catheters used in dialysis, and ventilator devices. 2,9 This infection is usually seen in immunocompromised states like malignancies, steroid use, immunodeficiencies, or chronic disease states like diabetes mellitus, chronic kidney disease, or chronic respiratory conditions. [1][2][3][4] According to a retrospective study done by Rohilla in a teaching school in Uttarakhand, diabetes mellitus and steroid use were the most common comorbid conditions in which S. paucimobilis infection was seen.…”

“…Being less virulent, this organism mainly affects individuals with an immunocompromised profile; which includes chronic conditions like diabetes mellitus, chronic kidney disease, chronic respiratory ailments, steroid-using patients with autoimmune diseases, or malignancies. [1][2][3][4] Such patients usually have a history of contact with health care. [1][2][3][4] Though infrequent, Sphingomonas paucimobilis may cause severe infection leading to septicemia, meningitis, septic arthritis, osteomyelitis, visceral abscess, enteritis, and keratitis.…”

“…[1][2][3][4] Such patients usually have a history of contact with health care. [1][2][3][4] Though infrequent, Sphingomonas paucimobilis may cause severe infection leading to septicemia, meningitis, septic arthritis, osteomyelitis, visceral abscess, enteritis, and keratitis. [2][3][4][5] Such cases are seen among both, pediatrics and adults.…”

“…[1][2][3][4] Though infrequent, Sphingomonas paucimobilis may cause severe infection leading to septicemia, meningitis, septic arthritis, osteomyelitis, visceral abscess, enteritis, and keratitis. [2][3][4][5] Such cases are seen among both, pediatrics and adults. 13 We here present a case of splenic and liver abscesses in a young male and more surprisingly in an immunocompetent patient with no contact with health care in the past.…”