Recurrent Pandoraea pnomenusa Catheter-Related Bloodstream Infections in an Immunosuppressed Child: A Case Report with Review of Literature

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Abstract The list of emerging pathogens is continuously expanding. Pandoraea pnomenusa is an emerging multidrug-resistant gram-negative bacterium reported in immunocompromised patients. This case report describes an 8-year-old pediatric patient with metastatic extrarenal rhabdoid tumor who developed recurrent catheter-related bloodstream infections (CRBSI) following the placement of a peripherally inserted central catheter (PICC). One month after PICC insertion, the child developed CRBSI. Blood cultures identified a gram-negative organism, which was subsequently identified as P. pnomenusa using matrix-assisted laser desorption/ionization-time of flight mass spectrometry. Initial antibiotic therapy resulted in transient improvement, but a second episode of CRBSI occurred with persistent positive cultures. The child was treated with a prolonged course of antibiotics and required PICC removal. Imipenem, tetracyclines, and co-trimoxazole are the preferred antibiotics for treating this pathogen. The awareness of P. pnomenusa as a rare but important cause of catheter-related infection is crucial for prompt identification and initiation of appropriate and effective antimicrobial therapy.

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