[MORAXELLA OSLOENSIS BACTEREMIA WITH PNEUMONIA: FIRST REPORTED CASE IN ISRAEL]

Community acquired pneumonia (CAP), an acute infection of the pulmonary parenchyma acquired in the community, is generally treated in an outpatient setting and involves different etiological agents. In the adult community, the most common pathogen in the disease is Streptococcus pneumonia, though other multiple etiological agents (atypical) have been involved, including Mycoplasma pneumoniae, Chlamydophila pneumoniae, and Legionella pneumophila. The genus Moraxella consists of aerobic, oxidase-positive gram-negative coccobacilli. Moraxella catarrhalis is known to be a common inhabitant of the upper respiratory tract and has been implicated as an etiologic agent in multiple diseases of the respiratory tract (but not limited to), such as bronchitis, pneumonia, otitis media, and sinusitis. The species Moraxella osloensis is a gram-negative opportunistic human pathogen, which has been found to cause several human diseases and infections such as meningitis, vaginitis, sinusitis, bacteremia, endocarditis, and septic arthritis. However, due to the subject's rarity, there is a paucity of information in the medical literature regarding its clinical significance, epidemiological data and appropriate therapy. We present the first case reported in Israel of Moraxella osloensis bacteremia in a patient with multiple co-morbidities including C. difficile infection (CDI) carrier state which presented with clinical symptoms (supported by radiological features) of community-acquired pneumonia. The patient was initially treated with empiric antibiotics including a 3rd generation cephalosporin and a macrolide that were substituted with IV Augmentin (Amoxicillin-Clavulanic acid) according to the organism's sensitivity tests. Our patient showed remarkable clinical and laboratory improvement with the therapy mentioned above.