Infective Endocarditis Caused by Pseudomonas luteola in a Pediatric Patient: A Case Report and Literature Review

Patient: Female, 9-year-old Final Diagnosis: Central line infection • infective endocarditis • Pseudomonas luteola Symptoms: Fever Medication: — Clinical Procedure: — Specialty: Infectious Diseases • Microbiology and Virology OBJECTIVE: Rare disease BACKGROUND: Pseudomonas luteola (P. luteola) is a Gram-negative, oxidase-negative bacillus. It is an environmental organism that is isolated from soil, water, and damp areas, and is rarely found as a human pathogen. Recently, it is increasingly considered as an important cause of hospital-acquired infections. Most infections in which P. luteola is implicated are associated with a breach in the immune barrier, such as indwelling catheters, prosthetic devices, immunocompromised conditions, and surgical wounds. Here, we present a rare case of infective endocarditis caused by P. luteola in a young female patient after being on a long-term peripherally inserted central venous catheter (PICC). CASE REPORT: A 9-year-old girl known to have Crohn’s disease and recurrent urinary tract infections, on prophylactic antibiotics, presented with an acute-onset abdominal pain associated with fever reaching 40C(o) and vomiting. She was placed on a peripherally inserted central line for total parenteral nutrition and developed sepsis on the 30(th) day of admission. Septic workup revealed P. luteola from both blood cultures and catheter tip cultures, with right atrial vegetation on echocardiogram. The diagnosis of infective endocarditis was confirmed and she was treatment with piperacillin/tazobactam for 6 weeks and had an uneventful recovery. CONCLUSIONS: P. luteola can be involved in serious infections in susceptible individuals. Serious outcomes may be associated with infective endocarditis, especially on a background of valvular prosthesis and central lines. The definitive treatment of catheter-related infective endocarditis caused by P. luteola is the removal of the lines, along with an appropriate antibiotic regimen-based antimicrobial susceptibility testing (AST) result.