DOI: https://dx.doi.org/10.18203/2320-6012.ijrms20222886
Published: 2022-10-28

Multiple hepatosplenic abscesses in an immunocompetent host

Jekishan J. Hirapara, Punam V. Bhende, Varin Rangwala, Jyoti G. Mannari

Abstract


Sphingomonas paucimobilis, a gram-negative organism, mainly infects immunocompromised hosts due to its low virulence. Patients with such an infection usually have contact with healthcare. Meningitis, peritonitis, visceral abscess, septic arthritis, septicemia, post-traumatic endophthalmitis, and keratitis are among the documented complications of Sphingomonas paucimobilis infection. Such an infection is rarely seen in the literature as the one causing splenic and liver abscess and that too in an immunocompetent host. We present a case of a 23-year-old immunocompetent male, who presented with fever and other constitutional symptoms with recent onset of abdominal pain and fullness. Splenic and liver abscesses were detected on radiology with the growth of only Sphingomonas on blood culture and negative reports for other organisms excluding the differentials, proving S.mobilis being the cause of the abscesses. The patient was managed on broad-spectrum antibiotics and additional medications for symptomatic relief. The patient gradually improved over 7 days of hospitalization. This case report mainly focuses on Sphingomonas paucimobilis infection, which is rarely seen and documented, and surprisingly in an immunocompetent host causing life-threatening infections and abscesses. Even though it’s a rare and a low virulence organism, such a presentation must not be overlooked. A regular and focused laboratory workup for detection and management, with adequate antibiotic treatment, is a must to avoid a poor prognosis.


Keywords


Sphingomonas paucimobilis, Immunocompetent host, Splenic abscess, Liver abscess

Full Text:

PDF

References


Ryan MP, Adley CC. Sphingomonas paucimobilis: a persistent Gram-negative nosocomial infectious organism. J Hosp Infect. 2010;75(3):153-7.

Birlutiu V, Dobritoiu SE, Ghibu AM, Birlutiu RM, Boicean LC. Sphingomonas paucimobilis - a rare cause of splenic abscesses: A case report. Medicine (Baltimore). 2022;101(1):e28522.

Rohilla R, Raina D, Singh M, Pandita AK, Patwal S. Evaluation of Sphingomonas paucimobilis as an emerging nosocomial pathogen in a teaching hospital in Uttarakhand. Iran J Microbiol. 2021;13(5):617-623.

Lin JN, Lai CH, Chen YH, Lin HL, Huang CK, Chen WF, Wang JL, Chung HC, Liang SH, Lin HH. Sphingomonas paucimobilis bacteremia in humans: 16 case reports and a literature review. J Microbiol Immunol Infect. 2010;43(1):35-42.

Hajiroussou V, Holmes B, Bullas J, Pinning CA. Meningitis caused by Pseudomonas paucimobilis. J Clin Pathol. 1979;32(9):953-5.

Charity RM, Foukas AF. Osteomyelitis and secondary septic arthritis caused by Sphingomonas paucimobilis. Infection. 2005;33(2):93-5.

Kuo IC, Lu PL, Lin WR, Lin CY, Chang YW, Chen TC, Chen YH. Sphingomonas paucimobilis bacteraemia and septic arthritis in a diabetic patient presenting with septic pulmonary emboli. J Med Microbiol. 2009;58(Pt 9):1259-63.

Yuen LC, Jackson T. A Case of Intra-abdominal abscess due to Sphingomonas paucimobilis in a patient on Peritoneal dialysis: A case report and review of literature. Indian J Nephrol. 2020;30(3):196-200.

Bavaro DF, Mariani MF, Stea ED, Gesualdo L, Angarano G, Carbonara S. Sphingomonas paucimobilis outbreak in a dialysis room: Case report and literature review of an emerging healthcare associated infection. Am J Infect Control. 2020;48(10):1267-9.

Agarwal R, Gagrani M, Mahajan A, Sharma N. Fulminant Sphingomonas paucimobilis keratitis: case study and review of literature. BMJ Case Rep. 2019;12(12):e231642.

Krziwon C, Zähringer U, Kawahara K, Weidemann B, Kusumoto S, Rietschel ET, Flad HD, Ulmer AJ. Glycosphingolipids from Sphingomonas paucimobilis induce monokine production in human mononuclear cells. Infect Immun. 1995;63(8):2899-905.

Ionescu MI, Neagoe DȘ, Crăciun AM, Moldovan OT. The Gram-Negative Bacilli Isolated from Caves-Sphingomonas paucimobilis and Hafnia alvei and a Review of Their Involvement in Human Infections. Int J Environ Res Public Health. 2022;19(4):2324.