Roseomonas Species Bacteremia With Associated Endocarditis and Possible CNS Septic Embolic Phenomenon

Rosemonas species has been associated with infections in both immunocompetent and immunocompromised hosts, manifesting as peritonitis, bacteremia, catheter-related bacteremia, endophthalmitis, spondylitis, and endocarditis. Here we present a man in his 60s who was brought to our institution for sudden onset of aphasia, right-sided paresthesia, and new onset tonic-clonic seizure episodes. At presentation, he was found to have severe lactic acidosis, acute kidney failure, bilateral hydronephrosis, elevated prostate-specific antigen (PSA), and an enlarged prostate. Blood cultures obtained on admission later grew Roseomonas species for which he was started on meropenem. A trans-esophageal echocardiogram (TEE) showed multiple very thin mobile densities on the ventricular side of the aortic valve; magnetic resonance imaging (MRI) of the brain revealed an 11 mm acute/subacute hemorrhage. The patient was discharged in stable condition on Ertapenem intravenous therapy for six weeks. Roseomonas mucosa can be a cause of endocarditis. The antimicrobial resistance profile of Roseomonas spp suggests that carbapenems, fluoroquinolones or aminoglycosides are the drugs of choice for Roseomonas infections and that infectious diseases involved in cases of Roseomonas infections should be instituted promptly for proper management.