Clinical characteristics and treatment outcomes of patients with pneumonia caused by Raoultella planticola

Exploring Raoultella planticola: Implications for Pediatric Health

The case presentation discusses the clinical evaluation and treatment of a two-year-old female exhibiting symptoms such as dysuria, constipation, and foul-smelling urine. Upon evaluation, the patient was found to be co-infected with Raoultella planticola and Escherichia coli. This co-infection poses unique challenges in diagnosis and treatment, as both pathogens may contribute to the manifestation of symptoms. The initial diagnosis of Raoultella planticola is notable, given its relatively rare occurrence and the potential for misdiagnosis. This case study contributes to our understanding of diagnosing and distinguishing symptoms at various stages of the illness, particularly in cases of co-infection. Following an initial urinalysis and urine culture confirming the presence of both pathogens, a 10-day course of antibiotics was prescribed. Subsequent examinations at Rady Children's Hospital-San Diego included kidney and abdomen imaging to rule out underlying issues. The co-infection underscores the importance of thorough diagnostic procedures and tailored treatment approaches. Additionally, it highlights the need for heightened awareness among healthcare providers regarding emerging pathogens and their potential clinical implications.

Raoultella planticola Pneumonia: A Rare Causative Organism

We present a case of Raoultella planticola (R. planticola) infection that resulted in community-acquired pneumonia in an immunocompetent patient with an eight-week history of productive cough. This gram-negative bacterium is typically found in the environment and has the potential to infect humans. Raoultella planticola infections in humans have been recorded in several case reports from throughout the world in recent years, usually affecting immunocompromised patients. Although R. planticola is sensitive to most antibiotic groups, recent studies have revealed an increase in the infrequent acquisition of resistance genes in R. planticola, such as carbapenem resistance, making this pathogen a potential emergent threat. Our patient acquired R. planticola pneumonia in the absence of any underlying risk factors, making this the first case in the UK of R. planticola causing community-acquired pneumonia in an immunocompetent person.

COVID-19 Bullous Lung Disease Superinfection by Raoultella planticola

Bullous lung lesions from coronavirus disease 2019 (COVID-19) pneumonia, causing pneumothorax, are a rare complication, affecting up to 1% of infected patients. Raoultella planticola is an aerobic, gram-negative bacteria known to cause opportunistic infection. We present a rare case of spontaneous pneumothorax from rupture of lung bulla as a late sequela from COVID-19 pneumonia and superinfection of the bulla by R. planticola. Although superinfection of bullous lesions is known, this is the first reported case of R. planticola pneumonia in a patient with COVID-19 lung bullae. COVID-19 patients are at heightened risk for bullous lung lesions and superinfection by opportunistic organisms; thus, they should be followed up closely.

Bacterial and Fungal Occurrence in Hydatid Cysts from Livestock in Central Iran

Echinococcus granulosus sensu lato causes Cystic echinococcosis. This study investigated the bacterial and fungal species in the liver and lung hydatid cysts obtained from sheep, goats, cattle, and camels slaughtered in Yazd abattoir, Central Iran. In this study, 84 hydatid cysts were obtained from 20 sheep, 13 goats, 25 cattle, and 26 camels. The fertility and viability rates were assessed using light microscopy and eosin staining, respectively. The aspirated hydatid cysts were cultured to detect the presence of any bacteria and fungi. Bacterial isolates were identified by biochemical tests. DNA was also extracted from germinal layers, and then genotyping was carried out targeting the cox 1 gene. The statistical analysis was performed by SPSS version 16.0. This study showed that 22.62% (19/84) of hydatid cysts had bacterial occurrence, and none of the samples had fungal species. Among the fertile cysts, 52.6% had bacterial occurrence, of which 40% were viable. Most bacteria detected in hydatid cysts included Staphylococcus saprophyticus, Escherichia coli, and S. epidermidis. Hydatid cysts with bacterial occurrence were identified as G1-G3, G5, and G6/G7. The bacterial species occurrence in hydatid cysts had no significant relationship with fertility and viability (P > 0.05), without any significant relation with viability (P > 0.05), animal species (P > 0.05), involved organ in animals (P > 0.05), and hydatid cyst genotypes (P > 0.05). It should also be mentioned that this is the first study to assess the relationship between hydatid cyst genotyping and the occurrence of fungal and bacterial species.

Myasthenic Crisis Precipitated by Raoultella Planticola in an Immunocompromised Host

We present a case of a 39-year-old male patient who was previously diagnosed with myasthenia gravis. He presented in a myasthenic crisis secondary to a lower respiratory tract infection, with the implicated organism being Raoultella planticola. He was referred to the intensive care unit (ICU) and required ventilatory support due to respiratory insufficiency. Early broad-spectrum antibiotics for a suspected bacterial infection were provided in combination with management specific to the myasthenic crisis. The patient made a full recovery and has displayed a good clinical response. This case report explores his presentation and aims to provide further literature on the incidence and description of R. planticola.

Microbiological and Clinical Aspects of Raoultella spp

The genus Raoultella was established in 2001. Species of Raoultella and Klebsiella share many ecological, biochemical, clinical, and microbiological features. Given the shortcomings of available technology for species identification in the clinical microbiology laboratory, are practically indistinguishable. Since the late 2000s there has been an increase in case reports of human Raoultella infections. Therefore, several authors are postulating that Raoultella spp. are rare and/or emerging pathogens.

Conclusions:Raoultella spp. are very similar to Klebsiella spp. The epidemiology and the clinical relevance of the human Raoultella spp. infections is uncertain and further studies are required. The previous difficulties in the identification of Raoultella spp. and the introduction of more precise identification techniques may explain the recent increase in the number of case reports. Raoultella spp. might be rather underdiagnosed than rare or emerging pathogens.

A 5-Year Retrospective Analysis of Raoultella planticola Bacteriuria

Introduction

Raoultella planticola is an aerobic gram-negative rod predominantly found in soil and aquatic environments. The typical reservoirs of Raoultella spp. include the gastrointestinal tract and the upper respiratory tract. It usually causes pneumonia, biliary tract infections, and bacteremia. Urinary tract infection (UTI) secondary to R. planticola is an uncommon entity. Less than 10 cases of R. planticola-associated UTIs in adults have been published in the literature to date.

Objective

This is a single institution retrospective study undertaken to identify the epidemiology, patient characteristics, clinical spectrum, predisposing risk factors and the outcome of patients with UTI caused by R. planticola.

Results

A total of 37 R. planticola isolates were identified in urine samples over a 5-year study period. The mean age of the patient population was 77 years. The most common comorbidity was diabetes mellitus, which was present in 16 patients. Only 3 patients had a history of steroid use, an immunosuppressive condition, or were on chemotherapy. The most common presenting complaint was altered mental status followed by fever. Resistance to ampicillin was found in 35 isolates which seems to be an intrinsic characteristic of Raoultella spp. and 2 isolates were multidrug-resistant, but still susceptible to ciprofloxacin. The average length of stay was 3 days, and the average duration of antibiotic administration was 8 days. Ciprofloxacin was the most frequently prescribed antibiotic (9 patients). The severity of infection ranged from simple cystitis in 15 patients to urosepsis in 2 patients and septic shock in 2 patients. There were no mortalities in our cohort.

Conclusion

Our study revealed that patients with R. planticola UTI had higher proportion of diabetes mellitus, renal failure compared to the general population. Our study also confirms the intrinsic resistance to ampicillin of Raoultella spp., which has been documented previously in the literature.

A novel case of Raoultella bacteremia secondary to liver abscess formation following transarterial chemoembolization

Raoultella planticola is an uncommon gram-negative bacterium that has rarely been identified as the causative organism in severe infections. Few cases have been described and have included patients with pneumonia, urinary tract infections or cholangitis. Only one case has reported to involve a liver abscess, thought to be from a primary urologic source. We describe the case of a 73-year-old man with recently diagnosed hepatocellular carcinoma who developed multiple pyogenic liver abscesses. The abscesses were thought to have developed in the setting of recent transarterial chemoembolization leading to R. planticola bacteremia noted on admission. Treatment with ceftriaxone and metronidazole was initiated in addition to drainage of the abscesses, resulting in decreased size of liver collections and initial clinical improvement. R. planticola remains a rare infectious organism in severe infections affecting both immunocompromised and immunocompetent individuals. Our patient’s underlying malignancy and recent transarterial chemoembolization likely placed him at risk of liver abscess formation complicated by bacteremia and sepsis.