Post-surgical Gangrene with Pseudomonas luteola Resulting in Limb Amputation: A Case Review

Abstract

Pseudomonas luteola is a rare infective agent with a variable resistance-sensitivity panel. Clinical suspicion and appropriate empiric treatment is necessary for resolution of such infections. We report a case of post-surgical gangrene as a result of Pseudomonas luteola culminating in limb amputation.

Pseudomonas Luteola Infection: First Case Report of Urinary Tract Infection and Review of Literature

“…In our case, the patient had a community acquired urinary tract infection by this bacterium. P. luteola has a variable sensitivity to penicillins, cephalosporins, tetracyclines, and cotrimoxazole and is often sensitive to imipenem, aminoglycosides and fluoroquinolones such as ciprofloxacin [4,8,9]. In our case, P. luteola was sensitive to piperacillin/ tazobactam, ceftazidime, cefepime, aztreonam and imipenem, but resistant to ampicillin, augmentin, cefotaxim, ceftriaxone, tigecycline, cotrimoxazole, amikacin, gentamicin, tobramycin and ciprofloxacin.…”

“…According to our research on Pub Med from 1980 until November 2020, we found only 19 cases of P. luteola's infection in adults. A summary of main features of these cases is put in Table 1 [1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. This [9,18,19], peritonitis [10,11], biliary tract infection [17], endophtalmitis [20,21] and cutaneous infection [5,7,8,12,14].…”

“…A summary of main features of these cases is put in Table 1 [1,[4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21]. This [9,18,19], peritonitis [10,11], biliary tract infection [17], endophtalmitis [20,21] and cutaneous infection [5,7,8,12,14]. To the best of our knowledge, our case is the first reported case of urinary tract infection caused by P. luteola.…”

“…We had no idea about the microorganism implicated in this recurent UTI but P. luteola can be the incriminated agent, in particular a strain resistant to imipenem and aminoglycosides. Due to its variable resistance pattern, P. luteola should be considered as a possible culprit when infections are unresolving, particularly in immunocompromised patients [8].…”

The Profile of Microbiological Pathogens in Diabetic Foot Ulcers

“…The findings of the present study are similar to those reported by Sugandhi et al ( 21 ). P. aeruginosa is commonly resistant to antibiotics and can cause severe tissue damage for diabetic patients, resulting in sepsis and amputation ( 21 – 23 ). In the current study, 15% of the patients infected with P. aeruginosa ultimately underwent amputation, and 50% of all the patients who underwent amputation in the study had P. aeruginosa infections.…”