Severe Systemic Chromobacterium violaceum Infection: A Case Study of a German Long-Term Resident in French Guyana.

Chromobacterium violaceum is a Gram-negative, facultative anaerobe proteobacterium. Its natural habitat is water and soil in tropical and subtropical regions. Human infections are characterized by rapid dissemination that can lead to high fatality rates. Here, we describe the first case of a C. violaceum infection reported from Germany. A German national with permanent residence in French Guyana contracted a C. violaceum infection presumably while bathing in a barrier lake in Brazil. The patient presented with a high fever and a crusty, erythematous skin lesion at an emergency department in Hamburg, Germany. Ultrasound and a CT scan of the abdomen revealed multiple liver abscesses. C. violaceum was detected in blood and from aspirates of the liver abscesses, using traditional culture methods and modern molecular assays. Prolonged treatment with meropenem and ciprofloxacin led to full recovery. Rapid pathogen detection and treatment initiation are of high importance in C. violaceum infections as mortality rates are overall declining but have still tended to reach up to 25% in recent years in systemic infections. Due to its broad natural drug resistance, antibiotic treatment is challenging. Increased travel activities may lead to more frequent presentation of patients with environmental pathogens of the tropics such as C. violaceum.