Sphingomonas Paucimobilis Pneumonia Complicated by Empyema in an Immunocompetent Patient: A Case Report and Concise Review of Literature

Sphingomonas paucimobilis is an aerobic, Gram-negative bacterium that is found widely in the environment and on hospital equipment. Although this organism usually causes infection in immunocompromised patients, it may cause pulmonary disease in immunocompetent patients, in rare cases. We report a case of Sphingomonas paucimobilis pneumonia complicated by empyema in an immunocompetent patient. We present a case of a 59-year-old female who was admitted for a congestive heart failure exacerbation and pneumonia. After imaging confirmed pneumonia and pleural effusion, monotherapy with levofloxacin was started. Thoracentesis revealed empyema caused by Sphingomonas paucimobilis. Despite chest tube placement, thoracoscopy with decortication was required due to continued clinical deterioration. After surgical intervention and an adjusted antibiotic regimen of cefepime, the patient clinically improved and was discharged. Upon follow-up, she had recovered completely with no residual disease. Alongside a concise review of the literature, our study highlights the importance of this infection in immunocompetent patients and advises providers to identify causes of aspiration when Sphingomonas paucimobilis empyema is diagnosed.