Sphingomonas paucimobilis presenting as acute phlebitis: A case report

Abstract

Sphingomonas paucimobilis is a strictly aerobic, non-spore-forming Gram-negative bacillus, ubiquitous bacterium, thought to be an opportunistic pathogen and is rarely reported in clinical settings. Here in, is the first case report of Acute Sphingomonas phlebitis secondary to intravenous (IV) drug use. We present the case of a 39-year-old male who initially presented with pain in his right upper extremity, fevers and chills of three week duration. He admitted to regularly injecting heroin in his distal right upper extremity with visible erythema, tenderness and streaking along the path of vein along the injection site. Radiographic studies including X-ray of the right arm, ultrasound and a subsequent MRI of the right arm were not significant for any osteomyelitis, deep venous thrombus, abscess, cellulitis, osteomyelitis, or pyomyositis. Blood culture grew Sphingomonas paucimobilis. Patient was initially started on vancomycin and piperacillin/tazobactam and subsequently switched to levofloxacin to complete a 14 day course. Patient admitted to using toilet water to mix his heroin which we suspect may have been the source of his bacteremia. Since it was first reported in 1979, a wide variety of community-acquired and hospital-acquired infections have been attributed to this Sphingomonas. It is ubiquitous to natural environment. We believe that due to its widespread habitat and ability to survive in stress conditions it could be a potential future threat in the era of increasing antimicrobial resistance globally. More research needs to be done on early identification, pathogenesis, treatment and eradication of the organism.

Complete genome sequence of Sphingomonas paucimobilis AIMST S2, a xenobiotic-degrading bacterium

“…One of the best known species of the genus is Sphingomonas paucimobilis as it was originally said to be the only species described in human infection 1,2 . It is a non-spore forming strictly aerobic, yellow-pigmented bacteria that can survive in low nutrient environment 1,3 . S .…”

Bleached Sphingomonas Paucimobilis

“…The genus Sphingomonas widely distributed in the nature, soil and water including the water sources in the hospital environment, contains at least more than 30 species, which of only paucimobilis is an occasional pathogen. Currently, there are more than 30 species with validly published names in the genus S. sensustricto [1][2][3][4][5][6][7][8][9][10][11][12].…”

“…Sphingomonas are ubiquitous bacteria that have been reported to be found in water (i.e. the pipes, bathtubs, distilled water, sea water, sea ice, river water, mineral water, haemodialysis fluid, ultrapure distilled water systems) the space shuttles and dental irrigation systems, nebulizers and hospital water systems and have colonised invertebrates collected from these water distribution systems [1][2][3][4][5][6][7][8][9][10][11][12]. Sphingomonas species have been linked to the death of coral reefs off the coast of Florida and some species are phytopathogenic such as Sphingomonas meloni [7].…”

“…However, S. paucimobilis is still regarded as the main pathogenic species of this genus [7]. It is thought to be opportunistic pathogen and rarely reported in the clinical settings [1]. Nowadays, most cases of Sphingomonas paucimobilis are health care associated, majority in immunocompromised hosts [1].…”

“…It is thought to be opportunistic pathogen and rarely reported in the clinical settings [1]. Nowadays, most cases of Sphingomonas paucimobilis are health care associated, majority in immunocompromised hosts [1]. It is one of the non-fermenting Gram-negative bacilli that is emerging as an opportunistic pathogen [7].…”