Chryseobacterium indologenes Infection in an Immunocompromised Patient - A Rare Case Report

Abstract

A 63-year-old male patient with diabetes mellitus, hypertension and chronic kidney disease who has been undergoing haemodialysis thrice weekly developed fever and shivering during haemodialysis for one week. He was doing haemodialysis from elsewhere and presented to nephrology department of our hospital with the same complaints. The patient had an intravenous catheter over left internal jugular vein, which was placed one month back from elsewhere for doing haemodialysis. He is a known case of diabetes mellitus and hypertension for the past ten years and on regular medications. On examination, the patient was moderately built and nourished, pallor was present and icterus, cyanosis, clubbing, lymphadenopathy, oedema were absent. His respiratory, cardiovascular, central nervous and gastro intestinal system examinations were within normal limit. The patient was febrile (101̊ F). pulse rate - 98/min, blood pressure – 150/80 mmHg, respiratory rate - 20 cycles per minute, fasting blood sugar - 140 mg/dl, Hb – 9 mg%, WBC count - 5600/μL. On local examination, mild erythema was noted over his neck on intravenous catheter site of left internal jugular vein. Other investigations were within normal limit. Human immunodeficiency virus (HIV), HBsAg and hepatitis C virus (HCV) antibodies were negative. The urine and sputum cultures were done to rule out any genitourinary or respiratory system involvement. Both cultures yielded no pathogens. The patient was treated with removal of internal jugular vein catheter, and a femoral vein catheter was placed. Blood and tip of intravenous catheter were sent to microbiology laboratory for culture and sensitivity testing. The patient was empirically started on intravenous antibiotic vancomycin.