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Treatment of Rhizobium radiobacter bacteremia in a critically ill trauma patient.
Ann Pharmacother. 2013 Nov; 47(11):1584-7.AP

Abstract

OBJECTIVE

To report the first case of Rhizobium radiobacter bacteremia in a critically ill trauma patient.

CASE SUMMARY

A 36-year-old female trauma patient hospitalized at The Regional Medical Center at Memphis developed bacteremia due to Rhizobium radiobacter on hospital day 9. The central line catheter tip culture from the same hospital day was negative. No source for the R radiobacter bacteremia was identified. Empirical and definitive antibiotic therapy consisted of cefepime 2 g intravenously every 8 hours for at total of 8 days. On completion of antibiotics, the patient demonstrated clinical resolution by immediate defervescence and gradual normalization of her white blood cell count. She demonstrated microbiologic success of therapy with negative blood cultures on hospital days 22, 34, 45, and 61. She was discharged on hospital day 80.

DISCUSSION

Rhizobium species are common soil and plant pathogens that rarely cause infections in humans. Previous reports of Rhizobium infections have been in immunocompromised patients; generally those with cancer or HIV infection. Intravenous catheters have commonly been cited as the source of infection. The trauma patient in this case constitutes a unique presentation of R radiobacter bacteremia when compared with other case reports. Her indwelling catheter was not the source of her infection, and her only identifiable risk factor for R radiobacter infection was hospitalization. However, she did possess potential reasons for development of an infection with an unusual organism such as R radiobacter. Potential immune modulating therapies included blood transfusions, opioid analgesics, benzodiazepines, general anesthetics, and surgical procedures. Finally, trauma itself has been associated with some degree of immunosuppression. All these issues may have placed the patient in this case at risk of an opportunistic infection like R radiobacter.

CONCLUSION

Based on this case, R radiobacter may be considered a potential pathogen causing bacteremia in critically ill trauma patients.

Authors+Show Affiliations

University of Tennessee Health Science Center, Memphis, TN, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

24259594

Citation

Ponnapula, Supriya, et al. "Treatment of Rhizobium Radiobacter Bacteremia in a Critically Ill Trauma Patient." The Annals of Pharmacotherapy, vol. 47, no. 11, 2013, pp. 1584-7.
Ponnapula S, Swanson JM, Wood GC, et al. Treatment of Rhizobium radiobacter bacteremia in a critically ill trauma patient. Ann Pharmacother. 2013;47(11):1584-7.
Ponnapula, S., Swanson, J. M., Wood, G. C., Boucher, B. A., Wells, D. L., Croce, M. A., & Fabian, T. C. (2013). Treatment of Rhizobium radiobacter bacteremia in a critically ill trauma patient. The Annals of Pharmacotherapy, 47(11), 1584-7. https://doi.org/10.1177/1060028013500942
Ponnapula S, et al. Treatment of Rhizobium Radiobacter Bacteremia in a Critically Ill Trauma Patient. Ann Pharmacother. 2013;47(11):1584-7. PubMed PMID: 24259594.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Treatment of Rhizobium radiobacter bacteremia in a critically ill trauma patient. AU - Ponnapula,Supriya, AU - Swanson,Joseph M, AU - Wood,G Christopher, AU - Boucher,Bradley A, AU - Wells,Diana L, AU - Croce,Martin A, AU - Fabian,Timothy C, Y1 - 2013/11/04/ PY - 2013/11/22/entrez PY - 2013/11/22/pubmed PY - 2014/7/22/medline KW - Rhizobium spp KW - bacteremia KW - critical care KW - infectious disease KW - trauma SP - 1584 EP - 7 JF - The Annals of pharmacotherapy JO - Ann Pharmacother VL - 47 IS - 11 N2 - OBJECTIVE: To report the first case of Rhizobium radiobacter bacteremia in a critically ill trauma patient. CASE SUMMARY: A 36-year-old female trauma patient hospitalized at The Regional Medical Center at Memphis developed bacteremia due to Rhizobium radiobacter on hospital day 9. The central line catheter tip culture from the same hospital day was negative. No source for the R radiobacter bacteremia was identified. Empirical and definitive antibiotic therapy consisted of cefepime 2 g intravenously every 8 hours for at total of 8 days. On completion of antibiotics, the patient demonstrated clinical resolution by immediate defervescence and gradual normalization of her white blood cell count. She demonstrated microbiologic success of therapy with negative blood cultures on hospital days 22, 34, 45, and 61. She was discharged on hospital day 80. DISCUSSION: Rhizobium species are common soil and plant pathogens that rarely cause infections in humans. Previous reports of Rhizobium infections have been in immunocompromised patients; generally those with cancer or HIV infection. Intravenous catheters have commonly been cited as the source of infection. The trauma patient in this case constitutes a unique presentation of R radiobacter bacteremia when compared with other case reports. Her indwelling catheter was not the source of her infection, and her only identifiable risk factor for R radiobacter infection was hospitalization. However, she did possess potential reasons for development of an infection with an unusual organism such as R radiobacter. Potential immune modulating therapies included blood transfusions, opioid analgesics, benzodiazepines, general anesthetics, and surgical procedures. Finally, trauma itself has been associated with some degree of immunosuppression. All these issues may have placed the patient in this case at risk of an opportunistic infection like R radiobacter. CONCLUSION: Based on this case, R radiobacter may be considered a potential pathogen causing bacteremia in critically ill trauma patients. SN - 1542-6270 UR - https://www.unboundmedicine.com/medline/citation/24259594/Treatment_of_Rhizobium_radiobacter_bacteremia_in_a_critically_ill_trauma_patient_ L2 - http://journals.sagepub.com/doi/full/10.1177/1060028013500942?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub=pubmed DB - PRIME DP - Unbound Medicine ER -