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Freifeld A, Bow E, Sepkowitz K, Boeckh M, Ito J, Mullen C. Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of America. [Internet]. Clinical Infectious Diseases; 2011. Available from: https://academic.oup.com/cid/article/52/4/e56/382256.

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Article

An Unusual Cause of Neutropenic Fever: Spontaneous Pantoea agglomerans Bacteremia in an Adult

1Department of Internal Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, 11203 USA


American Journal of Medical Case Reports. 2020, Vol. 8 No. 9, 289-292
DOI: 10.12691/ajmcr-8-9-9
Copyright © 2020 Science and Education Publishing

Cite this paper:
Victoria Zaccone, Mary Lockwood, Javier Ticona, Pedram Jouharian, Michelle Zamora, Christopher Hampton, Baho Sidiqi, Samir Kumar, Isabel M. McFarlane. An Unusual Cause of Neutropenic Fever: Spontaneous Pantoea agglomerans Bacteremia in an Adult. American Journal of Medical Case Reports. 2020; 8(9):289-292. doi: 10.12691/ajmcr-8-9-9.

Correspondence to: Isabel  M. McFarlane, Department of Internal Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, 11203 USA. Email: Isabel.McFarlane@downstate.edu

Abstract

Neutropenia is a serious complication found in immunocompromised patients, particularly those with cancer and human immunodeficiency virus (HIV). The etiology of neutropenia is multifactorial and can be caused by the direct effects of HIV infection, cytotoxic antineoplastic therapy, and malignancy. The main complication of neutropenia is a bloodstream infection caused by gram-positive bacteria (GPB) and gram-negative bacteria (GNB). GPB, specifically S. epidermidis, tend to affect cancer patients more often than GNB. However, GNB such as Pseudomonas aeruginosa have been associated with more serious infections. We report a case of neutropenic fever caused by a GNB, Pantoea agglomerans, in a 47-year-old Afro-Caribbean man with HIV and metastatic salivary adenocarcinoma. Pantoea agglomerans is a non-spore forming rod typically isolated from plants, fruits, and fecal matter, and is rarely pathogenic in humans. In the current literature, cases of P. agglomerans have been documented primarily in the pediatric population secondary to penetrating wound trauma. To our knowledge, this is the first case of spontaneous neutropenic fever secondary to P. agglomerans bacteremia in an Afro-Caribbean adult male.

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