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CC BY 4.0 · Indian J Med Paediatr Oncol
DOI: 10.1055/s-0045-1809972
Case Report with Review of Literature

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

Authors

  • Mohanaraj Ramachandran 

    1   Department of Pediatric Oncology, Cytecare Hospital, Bengaluru, Karnataka, India

  • Akshantha Sangannavar

    2   Department of Microbiology, Cytecare Hospital, Bengaluru, Karnataka, India

  • Divya Channegowda

    3   Department of Microbiology, Neuberg Anand Reference Laboratory, Bengaluru, Karnataka, India

  • Jily Joy

    4   Department of Infection Control, Cytecare Hospital, Bengaluru, Karnataka, India

  • Dhirjanand Kumar

    5   Department of Central Venous Access, Cytecare Hospital, Bengaluru, Karnataka, India

  • Prasad Narayanan

    6   Department of Medical Oncology, Cytecare Hospital, Bengaluru, Karnataka, India

  • Harish Pathalingappa

    6   Department of Medical Oncology, Cytecare Hospital, Bengaluru, Karnataka, India

  • Aparna Gangoli

    7   Department of Pathology, Cytecare Hospital, Bengaluru, Karnataka, India

  • Namita Ravikumar

    8   Department of Pediatric Intensive Care, MS Ramaiah Hospital, Bengaluru, Karnataka, India

Funding None.
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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.

Keywords

CRBSI - Pandoraea - immunocompromised - case report

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The authors confirm that all necessary patient consent forms have been obtained. The patient has provided written permission for their medical images and clinical details to be included in this publication. They have been informed that their identity will be protected by withholding their name and initials.




Publication History

Article published online:
03 July 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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