Successful treatment of a patient with recurrent infection of Chromobacterium violaceum

Abstract

Background Chromobacterium violaceum (C. violaceum) is a Gram-negative saprophytic bacterium that is widespread in tropical and subtropical environments, and belongs to conditional pathogenic bacteria. Human infection with C. violaceum is rare, and this can be fatal when the diagnosis and treatment are delayed, especially recurrent infection patients. Since clinicians lack the knowledge for C. violaceum, rapid diagnosis and early appropriate antimicrobial treatment remains challenging. Case presentation A 15-year-old male student was hospitalized for dark abscess, pustules, severe pain in both legs, and fever for 11 days. There were pustules with gray-white pus and red infiltrating plaques on the back, and the subcutaneous nodules could be touched in front of both tibias, with scab, rupture and necrotic tissue of the lower limb. The patient’s condition rapidly progressed. Therefore, next-generation sequencing (NGS), pustular secretion and blood culture were concurrently performed. The final diagnosis for this patient was C. violaceum infection by NGS. However, no bacterial or fungal growth was observed in the pustular secretion and blood culture. After 4 weeks of treatment, the patient was discharged from the hospital without any complications associated with C. violaceum infection. Conclusion Rapid diagnosis and early appropriate antimicrobial treatment is the key to the successful treatment of C. violaceum infection, especially in patients with sepsis symptoms. This case highlights that NGS is a promising tool for the rapid diagnosis of C. violaceum infection, preventing the delayed diagnosis and misdiagnosis of C. violaceum infection in patients who tested negative for pustular secretion and blood culture.

Sepsis and Hepatapostema Secondary to Chromobacterium Violaceum Infection on Lower Limb Skin: A Case Report

“…To date, there have been relatively few reported cases, with only a small proportion diagnosed by mNGS. 7 In our case, determining the source of fever and sepsis following the patient’s admission with lung infection and pleural effusion on chest CT necessitated differentiation. By obtaining blood samples, pus, and tissue samples from the infected area of the lower limb for routine bacterial culture and mNGS, we were able to detect C. violaceum by mNGS in both the blood and local tissue samples.…”

“…Distinct regions exhibit unique clinical features. [4][5][6][7][8][9] Notably, C. violaceum infections have an alarmingly high mortality rate, especially among individuals with sepsis, with reported mortality rates ranging from 57% to 80%. 10,11 Infection and Drug Resistance 2024:17 1003-1010…”

Clinical presentation and treatment of 2 patients with infection caused by Chromobacterium violaceum in Vietnam

“…Regarding treatment duration, in case 2 (see Table 2), after 2 weeks of treatment, clinical manifestations and inflammatory indices had returned to normal [13,14]. Based on available guidance from literature [2,4,15], the patient continued to receive antibiotic treatment and was monitored for a full 4 weeks. During this period, there were no further developments.…”