Molfa Minteh

Title: Brevundimonas vesicularis sepsis in a 2 month old infant in rural gambia: A case report

Abstract

Background: Brevundimonas vesicularis, a Gram-negative bacillus and non-lactose fermenter, is primarily found in both clinical and environmental samples. Although it rarely causes infections and is typically regarded as an opportunistic pathogen, it has been associated with cases of bacteremia, peritonitis, meningitis, arthritis, and skin infections. While there is high variability among cases, depending on site, infection severity, patient age, immune status, and geographic location, most cases occur in patients with underlying congenital conditions and immunocompromised individuals that could represent an emerging global concern, particularly in low- and middle-income countries.

Case presentation: We present a 2-month-old African male infant who exhibited signs of sepsis and cyanotic congenital heart disease. The blood culture identified Brevundimonas vesicularis. Antimicrobial susceptibility testing was performed, and the bacterium was found to be sensitive to all the antibiotics evaluated. We treated the child with the empiric first-line antibiotics IV amoxicillin clavulanate and IV gentamicin for six days. The child improved and was referred for an echocardiogram and cardiology review.

Conclusion: This report details a rare case of B. vesicularis sepsis in a 2-month-old infant with congenital heart disease in The Gambia. B. vesicularis is an emerging pathogen linked to opportunistic infections in patients with congenital disorders and immunocompromised individuals. It highlights comorbidities as key risk factors for acquiring B. vesicularis infection, underscoring the need for a multidisciplinary and holistic approach to improve clinical outcomes. Therefore, an improved surveillance system, skilled personnel, and adequate infrastructure are essential for early detection, accurate diagnosis, and effective management based on local antibiogram data to control antibiotic resistance.

The audience take away from presentation:

Emphasizing the rarity of Brevundimonas vesicularis infections and their clinical implication, highlighting the importance of early detection and antimicrobial management. Elaborating on the historical and microbiological details on B. vesicularis in the Abstract and its significance in resource-limited settings like rural Gambia, and to the larger context of global health challenges. Restructuring the differential diagnosis and physical examination findings of the case report into bullet points for readability. Comparing my findings with previously reported cases globally, particularly focusing on antimicrobial resistance patterns with construction of two small tables to help summarize this information. Stronger call to action for improving diagnostic capabilities and surveillance in sub-Saharan Africa at the conclusion part.