A rare cause of cellulitis and bacteremia by Achromobacter xylosoxidans in a patient with X-linked agammaglobulinemia: a case report
Abstract
Introduction and importance: Achromobacter xylosoxidans is a gram-negative bacillus typically found in the respiratory tracts of cystic fibrosis patients. While it is a known pathogen in respiratory infections, it infrequently causes skin and soft tissue infections (SSTIs). This case represents the first documented instance of A. xylosoxidans causing an SSTI in the USA to the best of our knowledge.
Case presentation: A 25-year-old male with X-linked agammaglobulinemia (BTK mutation) presented with 4 days of progressive left leg pain, swelling, and erythema. Blood cultures grew A. xylosoxidans, and the patient was diagnosed with cellulitis and bacteremia. He was initially treated with piperacillin/tazobactamand received a dose of intravenous immunoglobulin. Trimethoprim/sulfamethoxazole was prescribed upon discharge. The patient showed clinical improvement, with resolution of symptoms at follow-up.
Clinical discussion: Although rare, A. xylosoxidans infection should be considered a potential cause of SSTI-related bacteremia in immunocompromised patients. Initial empiric broad spectrum followed by de-escalation based on culture and susceptibility test is recommended.
Conclusion: Clinicians must be aware of A. xylosoxidans as a potential pathogen in SSTIs, especially in immunocompromised patients.
How strong is the evidence?
Evidence Hub reads this as a case report, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.
Read the paper
Related studies
- Horizontal gene transfer in the human gastrointestinal tract: potential spread of antibiotic resistance genes
- Mutation supply and relative fitness shape the genotypes of ciprofloxacin-resistant Escherichia coli
- Genomic Survey of E. coli From the Bladders of Women With and Without Lower Urinary Tract Symptoms
- Characterization of cefotaxime-resistant urinary Escherichia coli from primary care in South-West England 2017–18
- Fitness cost constrains the spectrum of marR mutations in ciprofloxacin-resistant Escherichia coli
- Emerging evidence-based innovative approaches to control catheter-associated urinary tract infection: a review
Go deeper in Evidence Hub
Evidence Hub adds a study data sheet (design, sample size, evidence level, key numbers), an AI summary and a chat grounded in the paper's text.