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Hydroxocobalamin is a treatment for cyanide toxicity with few side effects. We report a case of a hemodialysis patient whose treatment was compromised by hydroxocobalamin interference with the blood leak detector.

Patients with hematological malignancies are susceptible to unusual infections, because of the use of broad-spectrum anti-infective agents, invasive procedures, and other immunocompromising procedures and medications. Gordonia polyisoprenivorans, a ubiquitous environmental aerobic actinomycete belonging to the family of Gordoniaceae in the order Actinomycetales, is a very rare cause of bacteremia in these patients. We report the first case of pneumonia with associated bacteremia due to this organism, which was initially described in 1999 as a rubber-degrading bacterium following isolation from stagnant water inside a deteriorated automobile tire. We believe that hematologically immunocompromised patients on broad-spectrum antibiotics and with long-term central catheters select the possibility of infection with G. polyisoprenivorans. These infections can be prevented by handling catheters under aseptic conditions. We propose that blood cultures of persistently febrile neutropenic patients should be incubated for at least 4 weeks. Being a rare infection, there are no data available on treatment other than early removal of the foreign bodies.