Achromobacter piechaudii bloodstream infection in an immunocompetent host

BACKGROUND: Achromobacter piechaudii is a rare cause of clinical disease in humans. Previously, clinical disease has only been documented in immunocompromised patients. We present a case of Achromobacter piechaudii bacteremia in a patient with previous malignancy but no known immunosuppression. CASE REPORT: A 67-year-old man with distant history of colon and prostate cancer presented with low grade fevers and malaise. Blood cultures initially identified Alcaligenes xylosoxidans ss. denitrificans. Based on susceptibility testing, antibiotics were narrowed to levofloxacin. After further evaluation, the isolate was identified as Achromobacter piechaudii, an organism rarely previously seen only in immunocompromised patients. The source was felt to be dental infection after transesophageal echocardiogram and CT abdomen/pelvis were unrevealing. He improved with oral levofloxacin and dental extraction CONCLUSIONS: This is the first case report of primary Achromobacter piechaudii bloodstream infection in an immunocompetent host and adds to the growing list of clinical syndromes caused by this organism.