Pseudomonas Mendocina Bacteremia in a Hemodialysis Patient With a Central Venous Catheter

Pseudomonas mendocina Urinary Tract Infection: A Case Report and Literature Review

Pseudomonas mendocina is a Gram-negative bacillus from the family Pseudomonadaceae. The first P. mendocina-related infection was reported in 1992. Although a rare cause of infections, P. mendocina has been known to cause severe infections that require intensive treatment. We present the first documented case of urinary tract infection caused by P. mendocina.

An 83-year-old male with a past medical history of diabetes, hypertension, coronary artery disease, and prostate cancer with bone metastases, currently being treated with abiraterone and prednisone, presented with subjective fever, fatigue, altered mental status, dysuria, and hematuria of one-week duration. He was found to have a complicated urinary tract infection with an incidental asymptomatic COVID-19 infection on admission. The patient was empirically treated with ceftriaxone and switched to cefepime for broader coverage on day two of hospitalization. Urine culture reported the presence of P. mendocina with resistance only to fluoroquinolones. Ceftriaxone was reinstated. The patient was successfully treated with a seven-day course of ceftriaxone (days 1-3, days 6-7) and cefepime (days 4-5) but continued to remain inpatient for a later symptomatic COVID-19 pneumonia with discharge on day 15.

The majority of P. mendocina infections present as skin and soft tissue infections, infective endocarditis, meningitis, and bacteremia. Ours is the first documented case of urinary tract infection caused by P. mendocina, particularly in an immunocompromised COVID-19 patient, and the second to report P. mendocina with resistance to fluoroquinolones. This report contributes to the growing literature regarding P. mendocina-related infections.

A Case of Pseudomonas mendocina Bacteremia in an Elderly Man With Bilateral Leg Lesions

Pseudomonas mendocina is a gram-negative, aerobic, rod-shaped bacterium that rarely causes disease in humans. Documented infections can be severe with varying etiologies, often requiring intensive care. We describe a rare case of bacteremia with P. mendocina in an elderly male, with a comprehensive review of the literature.

An 81-year-old Caucasian male presented with bilateral lower leg erythema and drainage but was afebrile. His past medical history included atrial fibrillation, chronic kidney disease, and congestive heart failure. Labs showed leukocytosis and a blood culture was obtained revealing Pseudomonas mendocina. The pathogen was susceptible to all antibiotics tested and he was successfully treated on cefepime inpatient and a two-week course of ciprofloxacin on discharge.

Our case and literature review presents a successful treatment of a rare cause of bacteremia likely stemming from a soft tissue nidus. P. mendocina has a favorable susceptibility profile and the antibiotics preferred differ from Pseudomonas aeruginosa, a more common pathogen. Worldwide there have been only 18 other documented cases of P. mendocina infection, all successful and with no mortality. Physicians can confidently utilize usual antibiotics in the treatment of this pathogen despite its rare clinical manifestations.