SHM Converge Scientific Abstract ePoster Gallery-Air Jordaniae: Take Flight Through an Interesting Case of Cellulitis From H. Jordaniae

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This case describes a 77-year-old man with atrial fibrillation who developed worsening cellulitis of the left foot and elbow, accompanied by fever and altered mental status, despite outpatient cephalexin. One week earlier, he had fallen on a boat dock after swimming in a Delmarva Peninsula river and sustained a laceration to the plantar surface of his foot. Imaging showed cellulitis without abscess or necrotizing infection. Because of his freshwater exposure, antibiotics were broadened to ceftriaxone and doxycycline to cover waterborne gram-negative pathogens, including Vibrio species.<br /><br />Blood cultures initially showed gram-negative rods, but definitive identification took more than 21 days, during which more concerning pathogens such as Burkholderia pseudomallei were considered. The patient improved clinically and was discharged on intravenous ceftazidime plus oral doxycycline while awaiting final culture results. One week later, the organism was preliminarily identified as Haematospirillum jordaniae.<br /><br />The discussion highlights that H. jordaniae is an environmental gram-negative bacillus with emerging pathogenic potential and has been reported in fewer than 20 cases. Reported infections have mainly occurred in men with lower extremity injuries. The organism is associated with water contamination and has been isolated from industrial wastewater, emphasizing its environmental origin and the role of human activity in pathogen spread.<br /><br />This case underscores the importance of considering unusual waterborne organisms in cellulitis after freshwater exposure. It broadens the differential diagnosis beyond more common pathogens such as Vibrio, Pseudomonas, and Burkholderia species. Potential treatment options discussed include third-generation cephalosporins, ciprofloxacin, levofloxacin, and fluoroquinolones.

Asset Subtitle

Jillianne Santos

Meta Tag

Author List Chad Duffalo, Elizabeth Klingensmith, Jillianne Santos, Karlee Grudi, Sameer Akhtar

Category Clinical Vignettes

Concept Cellulitis

Concept Haematospirillum jordaniae

Concept Bacteremia

Concept Water Exposure

Concept Soft tissue infection

Distinguished Non-Finalist

Presenter Organization Philadelphia College of Osteopathic Medicine

Presenting Author Jillianne Santos

Track Adult

Keywords

cellulitis

freshwater exposure

Haematospirillum jordaniae

gram-negative rods

waterborne pathogen

atrial fibrillation

foot laceration

cephalexin failure

ceftazidime

doxycycline

Cellulitis

Haematospirillum jordaniae

Bacteremia

Water Exposure

Soft tissue infection