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Pseudoclavibacter otitis media in a 3-year-old boy with pulmonary and spinal tuberculosis
Satja Issaranggoon Na Ayuthaya1, Amornrut Leelaporn, Pattarachai Kiratisin
1From the Department of Pediatrics, Faculty of Medicine, Chiang Mai University, Chiang Mai (SInA, PO); and Department of Microbiology, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkoknoi, Bangkok, Thailand (AL, PK).
Abstract:
Pseudoclavibacter has rarely been documented as an etiologic agent of infection in humans. We presented the first case report of Pseudoclavibacter otitis media in a boy with pulmonary and spinal tuberculosis.A 3-year-old boy was referred to our hospital due to prolonged fever and progressive paraplegia for 3 months. He had yellowish discharge from both ear canals. The pleural fluid culture was positive for Mycobacterium tuberculosis. The discharge from both ears culture yielded yellow colonies of gram-positive bacilli with branching. This organism was positive for modified acid-fast bacilli stain but negative for acid-fast bacilli stain. Biochemical characteristics of this isolate were positive for catalase test but negative for oxidase, nitrate, esculin, and sugar utilization tests. The organism was further subjected to be identified by 16S ribosomal deoxyribonucleic acid gene sequencing. The result yielded Pseudoclavibacter species (99.4% identical), which could be most likely a potential pathogen in immunocompromised host like this patient. He responded well with intravenous trimetroprim-sulfamethoxazole for 6 weeks.This is the first case report of Pseudoclavibacter otitis media in children, and this case could emphasize Pseudoclavibacter species as a potential pathogen in immunocompromised host.
Insights
This case report details the first instance of Pseudoclavibacter otitis media in a child with tuberculosis. It highlights Pseudoclavibacter species as a potential pathogen in immunocompromised individuals.
Area of Science:
- Medical Microbiology
- Infectious Diseases
Background:
- Pseudoclavibacter species are rarely implicated in human infections.
- Otitis media is a common childhood infection, but rarely caused by unusual pathogens.
Observation:
- A 3-year-old boy with pulmonary and spinal tuberculosis presented with prolonged fever, paraplegia, and bilateral otitis media.
- Cultures from ear discharge revealed gram-positive bacilli with branching, positive for modified acid-fast stain.
- 16S ribosomal DNA sequencing identified the organism as Pseudoclavibacter species.
Findings:
- This is the first documented case of Pseudoclavibacter otitis media in a pediatric patient.
- The patient's infection was successfully treated with trimethoprim-sulfamethoxazole.
- The identification of Pseudoclavibacter as a causative agent in this immunocompromised host is significant.
Implications:
- This case expands the known spectrum of human infections caused by Pseudoclavibacter.
- It underscores the importance of considering unusual pathogens in immunocompromised patients with complex infections.
- Further research into Pseudoclavibacter pathogenicity and treatment is warranted.
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