SHM Converge Scientific Abstract ePoster Gallery-Mixta Calida as a Rare Cause of Central Line Infection

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A 33-year-old woman with a complicated right calcaneal fracture and prior polymicrobial osteomyelitis presented with 3 days of fever, chills, and malaise while receiving home IV daptomycin through a PICC line and oral amoxicillin-clavulanate. Because she had a history of a problematic heel wound and a new MRI showed a fluid collection near the Achilles tendon, the initial concern was recurrent infection of the foot. However, orthopedic and plastic surgery evaluations did not support the heel as the source.<br /><br />Blood cultures from both the PICC and peripheral veins grew Pantoea species, confirming bacteremia due to a central line infection. The organism was later identified as Mixta calida, formerly known as Pantoea calida. This is a rare environmental organism previously reported in a few human infections, including meningitis, device infection, and bacteremia, but this case was the first reported central line infection caused by Mixta calida.<br /><br />The PICC was removed, broad-spectrum antibiotics were started, and follow-up blood cultures at 72 hours showed clearance of the bacteremia. The patient’s symptoms improved quickly after line removal and treatment, and she was discharged on oral levofloxacin and metronidazole.<br /><br />The case highlights two important lessons: PICC lines used for outpatient parenteral antibiotic therapy carry an infection risk, and any septic patient with a PICC should be carefully evaluated for line-related infection. It also emphasizes that even when another source of infection seems likely, a broad and thorough workup is essential to reach the correct diagnosis.

Asset Subtitle

Natalya Tesdahl

Meta Tag

Author List Natalya Tesdahl, Srinivas Vunnam

Category Clinical Vignettes

Concept PICC Line

Concept Infection

Concept Catheter-Related Infection

Concept Sepsis

Concept Bloodstream Infection

Distinguished Non-Finalist

Presenter Organization University of Nebraska Medical Center

Presenting Author Natalya Tesdahl

Track Adult

Keywords

Mixta calida

Pantoea calida

central line infection

PICC line

bacteremia

osteomyelitis

calcaneal fracture

outpatient parenteral antibiotic therapy

blood cultures

catheter-related infection

PICC Line

Infection

Catheter-Related Infection

Sepsis

Bloodstream Infection