Severe Infection in a Full-Term Infant Caused by Pantoea dispersa: A Detailed Case Report

Healthcare professionals and researchers often deal with a myriad of infectious diseases that pose significant challenges. One such rare but severe infection is caused by the bacterium Pantoea dispersa. This case report details an infant who presented with critical signs of infection and how medical professionals treated the condition successfully.

Introduction

The case outlined here highlights the importance of accurate diagnosis and prompt treatment in Pediatric Infectious Diseases. A full-term infant with no history of surgical trauma or allergies was admitted to the hospital showing signs of severe infection.

Case Report

A full-term infant, in apparent good health, exhibited clear signs of infection upon arrival at the hospital. The child’s body temperature was 36.3°C, with a heart rate of 122 beats per minute and a respiratory rate of 26 breaths per minute. The patient was responsive to examination, and no rashes were observed.

Laboratory results showed a remarkably high white blood cell count of 30.5×10⁹/L, with 79.7% neutrophils. Additionally, the C-reactive protein (CRP) level was 27.2 mg/L, erythrocyte sedimentation rate (ESR) 32 mm/h, procalcitonin (PCT) 20.01 ng/mL, and a platelet count of 98×10⁹/L. These readings suggested a severe infection.

Following admission, meropenem at a dose of 0.25g intravenously every 8 hours was initiated. A blood culture bottle was sent for testing, which revealed gram-negative bacteria. Twenty-four hours later, white, smooth, and mucoid colonies were observed on the blood agar plate (Figure 1A).

X-ray scans showed increased lung texture, disorder, blurring, and flaky shadows on both lung fields, indicating pneumonia (Figure 1B). Ultrasonography indicated a potential area of fat infiltration in the left medial lobe of the liver (Figure 1C). Cardiac color Doppler ultrasonography identified a patent foramen ovale.

On the second day, meropenem treatment showed significant results, with inflammatory markers reducing (Table 1). Advanced identification through MALDI Biotyper and next-generation sequencing confirmed P. dispersa as the causative agent (Figure 1D, E). The bacterium exhibited sensitivity to several antibiotics.

Figure 1 Strain culture identification clinical examination (A) Colony and microscopical characteristics of P. dispersa. (B) The texture of both lungs was increased, disordered and blurred, and the shadow of the upper mediastinum was widened. (C) The left lobe of the liver shows enhanced echogenicity in the parenchyma, considered the possibility of fatty infiltration. (D) Mass spectrometry identification, compared to Pantoea dispersa UR1131_1_10ERL strain score of 2.037. (E) The phylogenetic tree analysis. The bacterial isolate was compared with 16S rDNA of other Pantoea isolates.

The dose of meropenem was adjusted to 20mg/kg iv every 8 hours. Following consistent treatment, the infant’s condition improved, fever subsided, and medical intervention was no longer required.

Literature Review

Pantoea dispersa has been identified as a causative agent in various infections in both plant and human subjects. Literature reports provide insights into its potential as a pathogen in different clinical settings. These findings underscore the necessity for thorough diagnosis and treatment.

Table 2 Previous Reports of Pantoea dispersa Infections

Discussion

The infant’s condition initially reflected as a severe infection, with marked increases in white blood cells and neutrophils, and reductions in platelets. This aligns with clinical presentations described in other P. dispersa infections. Advanced diagnostic methods confirmed the pathogen, preceding targeted antibiotic therapy.

The use of meropenem based on initial blood culture sensitivity profiles was a prudent choice in treating P. dispersa. Continued treatment saw a reduction in inflammatory markers, demonstrating the effectiveness of timely medical intervention.

Conclusions

Pantoea dispersa is an uncommon yet serious pathogen linked to bloodstream infections. Accurate identification is crucial, and the application of both routine and advanced diagnostic techniques can enhance this process. Effective antibiotic treatment and stringent infection control measures can prevent such infections.

In conclusion, this case emphasizes the importance of comprehensive diagnostic tools and thoughtful antibiotic protocols in medical practice. Ensuring precision and speed in diagnosis and treatment are vital for positive patient outcomes.

Data Sharing Statement

The datasets used and/or analyzed during this study are available from the corresponding author on reasonable request.

Ethics Statement

This study received ethical approval from the Ethical Review Committee of Children’s Hospital Affiliated to Shandong University (approval no. SDFE-IRB/P-2022017).

Consent to Publish

Acknowledgment

Funding for this study was provided by the Shandong Provincial Clinical Research Center for Children’s Health and Disease and a special fund for high-level talents in the medical and health industry of Jinan City.

Disclosure

The authors declare no competing interests in this work.

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