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Pseudomonas mendocina Urinary Tract Infection: A Case Report and Literature Review
Thy Vo1, Nodari Maisuradze2, David Maglakelidze3
1Internal Medicine, State University of New York (SUNY) Downstate College of Medicine, Brooklyn, USA.
Abstract:
Pseudomonas mendocina is a Gram-negative bacillus from the family Pseudomonadaceae. The first P. mendocina-related infection was reported in 1992. Although a rare cause of infections, P. mendocina has been known to cause severe infections that require intensive treatment. We present the first documented case of urinary tract infection caused by P. mendocina. An 83-year-old male with a past medical history of diabetes, hypertension, coronary artery disease, and prostate cancer with bone metastases, currently being treated with abiraterone and prednisone, presented with subjective fever, fatigue, altered mental status, dysuria, and hematuria of one-week duration. He was found to have a complicated urinary tract infection with an incidental asymptomatic COVID-19 infection on admission. The patient was empirically treated with ceftriaxone and switched to cefepime for broader coverage on day two of hospitalization. Urine culture reported the presence of P. mendocina with resistance only to fluoroquinolones. Ceftriaxone was reinstated. The patient was successfully treated with a seven-day course of ceftriaxone (days 1-3, days 6-7) and cefepime (days 4-5) but continued to remain inpatient for a later symptomatic COVID-19 pneumonia with discharge on day 15. The majority of P. mendocina infections present as skin and soft tissue infections, infective endocarditis, meningitis, and bacteremia. Ours is the first documented case of urinary tract infection caused by P. mendocina, particularly in an immunocompromised COVID-19 patient, and the second to report P. mendocina with resistance to fluoroquinolones. This report contributes to the growing literature regarding P. mendocina-related infections.
Insights
This case report details the first urinary tract infection caused by Pseudomonas mendocina in an immunocompromised patient. The rare bacterium, Pseudomonas mendocina, was successfully treated with antibiotics, contributing to understanding its clinical presentations.
Area of Science:
- Medical Microbiology
- Infectious Diseases
- Clinical Case Reports
Background:
- Pseudomonas mendocina is a Gram-negative bacillus rarely associated with severe human infections.
- Previous P. mendocina infections typically involve skin, soft tissues, endocarditis, meningitis, or bacteremia.
Observation:
- An 83-year-old immunocompromised male with multiple comorbidities presented with symptoms of a complicated urinary tract infection.
- The patient was incidentally found to have asymptomatic COVID-19 infection upon admission.
- Urine cultures identified Pseudomonas mendocina, exhibiting resistance solely to fluoroquinolones.
Findings:
- This represents the first documented case of a urinary tract infection caused by Pseudomonas mendocina.
- The patient received a combination therapy of ceftriaxone and cefepime for seven days.
- The Pseudomonas mendocina infection was successfully treated, and the patient recovered.
Implications:
- This case expands the known spectrum of clinical manifestations for Pseudomonas mendocina infections.
- It highlights the importance of considering rare pathogens in complex patient cases, especially those who are immunocompromised.
- The findings contribute to the limited literature on Pseudomonas mendocina, particularly its antimicrobial resistance patterns.
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