Case report: Rare case Pandoraea ssp causing bacteremia associated with CRBSI in patients with hydrocephalus post intraventricular hemorrhage drain revision at Prof. Ngoerah Hospital, Denpasar, Bali
1 Clinical Microbiology Specialist Study Program, Faculty of Medicine, Udayana University, Bali, Indonesia.
2 Department of Clinical Microbiology, Faculty of Medicine, Udayana University, Bali, Indonesia.
3 Department of Neurosurgery, Faculty of Medicine, Udayana University, Bali, Indonesia.
4 Prof. Dr. IGNG Ngoerah Central General Hospital, Denpasar, Bali, Indonesia.
Case Study
GSC Biological and Pharmaceutical Sciences, 2024, 27(01), 223–228.
Article DOI: 10.30574/gscbps.2024.27.1.0148
Publication history:
Received on 11 March 2024; revised on 19 April 2024; accepted on 22 April 2024
Abstract:
Introduction: Pandoraea species is a multidrug-resistant, gram-negative bacillus usually isolated from patients with cystic fibrosis (CF) and also commonly found in water and soil. Bloodstream infection with Pandoraea ssp in non-CF patients is uncommon. We report the first case of post-revision VP shunt hydrocephalus with bacteremia and associated CRBSI caused by Pandoraea ssp.
Case description: A 50-year-old Balinese man with underlying disease of sepsis by Pandoraea ssp. after several histories of surgery, a patient with non-communicating hydrocephalus and intraventricular hemorrhage after endoscopic Intra Ventricular Hemorrhage evacuation and revision of the proximal shunt. The patient complained of being unconscious for 2 days, slurred speech, weakness in half of the body, vomiting once, seizures, and a fever. The CVC device was installed for 20 days, and he had a fluctuating fever during the hospitalization. Ceftriaxone and levofloxacin were given intravenously for empiric treatment. Pandoraea ssp. were isolated from both his blood samples and exit site; once the pathogen and drug sensitivity were confirmed, levofloxacin was planned for definitive treatment. One month after the patient was admitted, his condition worsened and he was pronounced dead.
Discussion: Pandoraea ssp. had been reported in this patient with multiple organ dysfunction as a complicating factor. In our case, the potential source of this bacteria was considered to be contamination from the environment. This infection is considered CRBSI during hospitalization. This bacteria is multi-drug-resistant, which makes treatment of Pandoraea infections complicated.
Conclusion: The finding case will be beneficial to clinicians because it provides additional information about the lesser-known Pandoraea species.
Keywords:
Pandoraea spp; Catheter-related bloodstream infection; Case report; Multidrug-resistant
Full text article in PDF:
Copyright information:
Copyright © 2024 Author(s) retain the copyright of this article. This article is published under the terms of the Creative Commons Attribution Liscense 4.0
