Gani Melony, Rao Sanjana, Miller Matthew, Scoular Sarah
Skaggs School of Pharmacy and Pharmaceutical Sciences, University of Colorado, Aurora, CO, USA.
Department of Pharmacy, University of Colorado Hospital, Aurora, CO, USA.
Am J Case Rep. 2019 Apr 5;20:453-458. doi: 10.12659/AJCR.914360.
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 (CD⁴ count on admission <10 cells/mm³) 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/mm³. 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.
门多萨假单胞菌是一种革兰氏阴性、需氧、杆状细菌，属于假单胞菌科。在自然界中，门多萨假单胞菌已从水和土壤样本中分离出来。该菌种很少引起人类疾病，不过已有导致住院和重症监护的严重感染的记录。本病例可能是美国第二例报告的与门多萨假单胞菌相关的感染病例。在本病例报告中，我们分析了一名严重免疫功能低下的获得性免疫缺陷综合征（AIDS）患者的门多萨假单胞菌感染的临床和实验室特征，并回顾了现有文献。病例报告：一名64岁白人男性，有显著的人类免疫缺陷病毒（HIV）/AIDS病史（入院时CD⁴细胞计数<10个/mm³），于1988年确诊，自1992年起接受抗逆转录病毒治疗，因疑似侵袭性霉菌感染入住我院进行急性处理。住院第20天，患者体温升至39.9°C，乳酸水平升高至2.6 mmol/L，绝对中性粒细胞计数大于1000个/mm³。住院第22天，两组血培养均显示门多萨假单胞菌阳性。抗生素治疗降级为头孢他啶，经过10天的总疗程治疗后，患者成功出院。结论：世界上已报告14例门多萨假单胞菌病例。4例表现为脑膜炎，5例表现为心内膜炎。除了典型的抗假单胞菌药物外，报告的病例中有2例显示门多萨假单胞菌对磺胺甲恶唑/甲氧苄啶和头孢曲松等抗生素敏感。所有记录在案的门多萨假单胞菌感染病例报告均通过抗生素治疗成功治愈，患者存活。
