Septic shock caused by Rhizobium radiobacter in an elderly woman: A case report

RATIONALE: Rhizobium radiobacter is a Gram-negative pathogen present in soil and plants. Cases of R radiobacter infection in immunocompromised hosts have been sporadically reported. However, septic shock caused by R radiobacter is rarely seen. PATIENT CONCERNS: Here, we describe an elderly patient with a rapid progression of watery diarrhea, anorexia, fever, weakness, oliguria, and shock. Blood results showed increased total white blood cell count and C-reactive protein. Arterial blood gas results showed hypoxia and elevated lactate level. The Sequential Organ Failure Assessment score was 11. Blood culture at admission showed Gram-negative bacteria, which were later confirmed as R radiobacter. DIAGNOSIS: Septic shock caused by R Radiobacter. INTERVENTIONS: The patient was treated with intravenous cefoperazone/sulbactam and sequential oral levofloxacin. OUTCOMES: The patient recovered completely. CONCLUSION: R radiobacter may be considered as a potential opportunistic pathogen that may cause severe sepsis in elderly patients, especially those with multiple underlying diseases.