Related Experiment Video
Updated: Jul 7, 2025
Visualization of Pseudomonas aeruginosa within the Sputum of Cystic Fibrosis Patients
Published on: July 16, 2020
A rare case of Sphingomonas paucimobilis ventriculitis
1MD, Division of Clinical Care and Research, Institute of Human Virology, University of Maryland School of Medicine, 725 west Lombard Street, Baltimore, Maryland, 21201, USA.
Introduction:
Nosocomial ventriculitis is a severe infection that habitually plagues neurological intensive care units. It is usually associated with external ventricular drains. Unfortunately, classic cerebral spinal fluid parameters are less specific and sensitive compared to community acquired meningitis. This is in part secondary to indolent bacteria commonly infecting external ventricular drains leading to ventriculitis.
Case Report:
Herein, a rare case of Sphingomonas paucimobilis ventriculitis in an immunocompetent host is reported. The patient had classic symptoms of ventriculitis, but her cerebral spinal fluid parameters were benign and initial cultures were negative. Consequently, treatment was tailored to an assumed respiratory infection only to have recurrence of her symptoms. Repeat analysis of her cerebral spinal fluid was again benign, but her cerebral spinal fluid culture grew S. paucimobilis. Subsequently, the patient was treated with cefepime, which resolved her symptoms. She completed a two-week course and has had no recurrence of her infection.
Conclusions:
This case reinforces the need for clinicians to have heightened awareness of this emerging pathogen, its antibiotic resistance patterns, and the unique composition of this bacterium's cell wall which has ramifications on disease presentation.
Insights
Nosocomial ventriculitis, often linked to external ventricular drains, can be challenging to diagnose. A rare case highlights Sphingomonas paucimobilis as a cause, emphasizing the need for awareness of this pathogen.
Area of Science:
- Infectious Diseases
- Neurology
- Microbiology
Background:
- Nosocomial ventriculitis is a severe complication in neurological intensive care units, frequently associated with external ventricular drains.
- Standard cerebrospinal fluid parameters often lack sensitivity and specificity for diagnosing ventriculitis caused by indolent bacteria.
- External ventricular drains are a common risk factor for developing nosocomial ventriculitis.
Observation:
- A rare case of Sphingomonas paucimobilis ventriculitis occurred in an immunocompetent patient.
- The patient presented with classic ventriculitis symptoms, yet cerebrospinal fluid parameters were initially benign with negative cultures.
- Despite initial misdiagnosis and treatment for a respiratory infection, symptoms recurred.
Findings:
- Cerebrospinal fluid cultures eventually identified Sphingomonas paucimobilis as the causative agent.
- The patient's ventriculitis resolved after treatment with cefepime.
- A two-week course of cefepime led to no recurrence of the infection.
Implications:
- Clinicians require heightened awareness of Sphingomonas paucimobilis as an emerging pathogen in ventriculitis.
- Understanding the antibiotic resistance patterns of Sphingomonas paucimobilis is crucial for effective treatment.
- The unique cell wall composition of Sphingomonas paucimobilis may influence disease presentation and diagnostic challenges.
