CASE REPORT: Ralstonia Picketii Bacteremia IN A PREVIOUSLY HEALTHY BIOLOGIST
G.R. Martins, P.G.G. Costa, A.F.A. Bastos, T.A.C. Lamounier, S.S.S. Costa, H.M.S. Pinhati, S.M. Domingue Jr.
Laboratório Sabin de Análises Clínicas - Instituto Sabin, Brasília, Brazil e Hospital Santa Luzia, Brasília, Brazil
Ralstonia pickettii is a non-fermenting Gram-negative bacillus that is an infrequent pathogen. It can be isolated from water, soil and plants, and can also from part of the commensal flora of the oral cavity and qhe upper respiratory tract of healthy individuals. Infections may occur in immuno-compromised patients, caused by contaminated solutions, respiratory therapy solutions, skin disinfectants, blood culture mediums, and water supplies. We report a case of Ralstonia pickettii bacteremia in a 21 years old previously healthy woman, biologist that works in a research laboratory. The patient presented recurrent fever, arthragias for two weeks and the blood culture suggested gram-negative bacilli. She was treated with cyprofloxacin for 7 days without remission of symptons. Clinical investigation was performed and endocarditis, pneumonia, ans infectious, rheumatic and oncologic causes of immunodeficiency were excluded. The blood culture isolated Ralstonia picettii in agar medium but not in Mac Conckey medium. She was than successfully treated with ceftriaxone. In order to clarify the possible sources of the bacteria, we invstigated all solutions used on the research laboratory were the patient works, and all the cultures were negative. The misinterpretation and non recognition of Ralstonia pickettii as a pathogen may cause a considerable delay in the diagnostic process. This bacteria must be considered as an important pathogen in people that work with potencial contaminated solutions.