SHM Converge Scientific Abstract ePoster Gallery-A Unique Case of Pseudomonas Mendocina Sepsis

Pdf Summary

A 70-year-old man with recent COPD exacerbation and ongoing prednisone taper presented with acute right leg redness, swelling, and pain after working as a landscaper in a field of tall grass that had been watered with non-potable pond water. He noticed multiple small abrasions and embedded grass fragments on both lower legs, followed the next day by progressive cellulitis symptoms. On exam he was tachycardic with marked erythema and edema of the right lower extremity below the knee. Labs showed leukocytosis, elevated procalcitonin, and mildly elevated lactate; venous Doppler was negative for DVT. He was treated initially with IV vancomycin and ceftriaxone.<br /><br />Within 48 hours, all admission blood cultures grew Pseudomonas mendocina, a very rare environmental gram-negative organism associated with soil and untreated water. Antibiotics were changed to IV cefepime, and the patient completed a 10-day course with full resolution of infection.<br /><br />The report highlights that P. mendocina is an uncommon cause of cellulitis and sepsis, with fewer than 20 human infections described and only a few involving skin and soft tissue. Environmental exposure plus skin disruption should raise suspicion, and patients generally respond well to anti-pseudomonal therapy with excellent prognosis.

Asset Subtitle

Noah Nigro

Meta Tag

Author List Charles J. Van Hook, Jessica M. Altree, Noah Nigro

Category Clinical Vignettes

Concept Pseudomonas mendocina

Concept Cellulitis

Concept Sepsis

Concept Skin disruption

Concept Soft tissue infection

Distinguished Non-Finalist

Presenter Organization University of Colorado School of Medicine

Presenting Author Noah Nigro

Track Adult

Keywords

Pseudomonas mendocina

cellulitis

bacteremia

soil exposure

non-potable water

skin abrasions

soft tissue infection

cefepime

COPD exacerbation

environmental gram-negative organism

Pseudomonas mendocina

Cellulitis

Sepsis

Skin disruption

Soft tissue infection