First reported human Castellaniella defragrans bacteraemia: a case report.
Morgane Nédellec, Titouan Cerruti, Damien Jacot et al.
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Case in brief
An 82-year-old man with monoclonal B-cell lymphocytosis, later diagnosed with chronic lymphocytic leukaemia, presented with fever, confusion, and signs of sepsis. Blood cultures revealed sustained growth of Castellaniella defragrans for 7 days. Imaging showed pulmonary consolidations and mediastinal infiltration. The patient was treated with high-dose meropenem, leading to clearance of the bacteraemia and clinical improvement over five weeks.
What made this case unusual
This case is notable as it represents the first documented instance of Castellaniella defragrans causing bacteraemia in a human, highlighting its potential pathogenicity in immunocompromised individuals.
Diagnostic / clinical pearl
Clinicians should consider environmental microorganisms like Castellaniella defragrans as potential pathogens in immunocompromised patients presenting with sepsis.
Why it matters
This case underscores the importance of recognizing non-traditional pathogens in patients with weakened immune systems, which can lead to severe infections.