A Cutaneous Infection Caused by Brevundimonas Vesicularis: A Case Report

Abstract

Brevundimonas vesicularis is a non-fermenting gram-negative bacillus, aerobic and motile. This microrganism is ubiquitous in the environment and has rarely been implicated in human infections. We present the second case of cutaneous infection caused by B. vesicularis in an immunocompetent patient.Brevundimonas vesicularis is an aerobic nonsporulating and non-fermenting gram-negative bacillus (1) that is ubiquitous in the environment (2-6).Two species originally described as Pseudomonas diminuta and Pseudomonas vesicularis were re-classified by Segers et al. into a new genus Brevundimonas with Brevundimonas diminuta as the type species of the genus (7). Brevundimonas vesicularis represent a separate line in the usubclass of Proteobacteria, rarely encountered in human infection. It was first described under the name of Corynebacterium vesiculare by Busing et al. (8) and Busing and Freytag (9) who isolated it from a medicinal leech (Hirsuda medicinalis). In 1994 Segers et al. re-classified two species originally described as Pseudomonas diminuta and Pseudomonas vesicularis into a new genus Brevundimonas with Brevundimonas diminuta as the type species of the genus (7). This organism has been very rarely implicated in human infections. We present the second case of cutaneous infection caused by B. vesicularis in an immunocompetent patient. MATERIALS AND METHODSIn February 2007 a 71-year-old caucasian man was referred to our Department of Dermatology, because of a rapidly enlarging skin plaque on his right forearm which had appeared 2 weeks previously and had already been treated with topical (mupirocin 2 g/lOO g cream) and systemic antibiotic (proxetil cefpodoxime 200 mg x 2 die for 7 days) without any improvement.On physical examination, an irregular rectangular erythematous plaque with superficial bright red erosions, micro-pustules and crusting on the surface, measuring approximately 13 x 4 em, was present on the dorsal aspect of his right forearm. The lesion was painful.The patient lived in a rural area and was usually exposed to farm animals. He reported that some days before the onset of the skin lesion he had a trauma on his right forearm whilst handling fodder. Past medical history was unremarkable. The physical examination was normal. Laboratory tests were normal except for

Brevundimonas vesicularis bacteremia: A rare case report in a female infant

“…[1,[3][4][5][6][7] Few cases of B. vesicularis infection were attributed to nosocomial sources [1,2,5,6] and some cases to community sources. [4,[7][8][9] In majority of the cases underlying diseases or predisposing factors such as biliary pancreatitis, acute myelogenous leukemia, mitral valve stenosis, sickle cell anaemia with functional asplenia and end-stage renal disease treated by haemodialysis contributed to B. vesicularis infections due to the patients' immunocompromised state. [1,[5][6][7]10] B. vesicularis infection has, therefore, been classified as opportunistic.…”

“…Few cases have been reported in immunocompetent patients. [4,8,9] B. vesicularis has been isolated from other samples also; in the case of keratitis following in situ keratomileusis, cutaneous infection, septic arthritis, peritonitis. [2,[8][9][10] The low number of cases reported of B. vesicularis infection in humans limits the body of knowledge on the spectrum of disease caused by this pathogen as well as optimal treatment regimens.…”

Brevundimonas spp: Emerging global opportunistic pathogens

“…[ 29 ], B. vesicularis 2008 F/17 France Cystic Fibrosis Pneumonia Amikacin, Ceftriaxone, Gentamicin, Imipenem, Isepamicin, Rifampicin, Piperacillin/tazobactam, Ticarcillin, Ticarcillin- Clavulanate, Tobramycin Amoxicillin, Amoxicillin-Clavulanate, Ceftazidime, Ciprofloxacin, Colistin, Trimethoprim-Sulfamethoxazole Imipenem, Tobramycin Complete recovery Panasiti et al. [ 73 ], B. vesicularis 2008 M/71 Italy None Cutaneous Infection/CA Amikacin, Cefoxitin, Ceftazidime, Cefuroxime, Cefalotin, Cepodoxime, Gentamycin, Tobramycin Amoxicillin-Clavulanate, Cefeoime, Ofloxacin, Norfloxacin Amoxicillin-Clavulanate Complete recovery Viswanathan et al. [ 74 ], B. vesicularis 2009 M/Infant India Newborn Sepsis/HA Amikacin, Cefotaxime, Ciprofloxacin, Gentamicin, Meropenem, Ofloxacin, Piperacillin tazobactam N/A Amikacin, Cefotaxime Complete recovery Chandra et al.…”

Brevundimonas vesicularis Causing Bilateral Pneumosepsis in an Immunocompetent Adult: A Case Report and Literature Review

“…From the literature search, we identified a total of 78 cases, from 21 case reports and 3 case series (where a case series was defined as n ≥ 4), describing B. vesicularis as a causative pathogen. [2][3][4][5][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25][26][27][28] There was high variability among the cases as to the site and severity of infection, the age and immune status of the patient, and the geographic location. However, most cases occurred in immunocompromised adults and were described as bacteremia or sepsis, with no focus of infection reported.…”