Rare Urinary Tract Infection by Rodentibacter pneumotropicus (formerly, Pasteurella pneumotropica) in an Immunocompetent Patient.

Abstract

BACKGROUND Pasteurella pneumotropica has been reclassified as Rodentibacter pneumotropicus after advancements in genetic and phenotypic analyses revealed genetic diversity and phylogenetic distinctions within the pneumotropica complex. This reorganization resolved issues of misclassification and provided a clearer framework for understanding the epidemiology and clinical relevance of these organisms. R. pneumotropicus is a gram-negative bacillus commonly found in the respiratory tracts of mammals, particularly rodents. However, it rarely infects humans. This case is notable for presenting a urinary tract infection caused by R. pneumotropicus in an immunocompetent patient, a rare manifestation highlighting the need to consider less-common pathogens in daily clinical practice to choose the correct treatments. CASE REPORT This case describes a 37-year-old immunocompetent man who initially presented to a hospital in Mexico with gastrointestinal symptoms and later developed urinary issues following a ureteroscopy for a proximal ureteral stone. Despite initial treatment with meropenem and paracetamol, the patient had persistent fever and leukocytosis. According to the available material at the hospital, a urine culture was done subsequently and it revealed R. pneumotropicus, formerly known as Pasteurella pneumotropica, which was sensitive to fluoroquinolones. The patient underwent transurethral resection of the prostate and was treated with ciprofloxacin, leading to successful symptom resolution. CONCLUSIONS This case highlights the rarity of urinary tract infections caused by R. pneumotropicus in immunocompetent individuals. These findings underscore the importance of considering uncommon microorganisms in differential diagnoses and ensuring precise identification and sensitivity testing to guide effective treatment. Also, it provides evidence supporting the ability of R. pneumotropicus to infect immunocompetent individuals, raising several questions related to its infection mechanisms.