SHM Converge Scientific Abstract ePoster Gallery-Septic Shock Due to Pantoea Spp. In an Immunocompetent Patient

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This case report describes a rare episode of septic shock caused by <strong>Pantoea spp.</strong> in a <strong>65-year-old immunocompetent man</strong>. Pantoea are gram-negative bacilli commonly found in plant and soil debris and are more often linked to neonatal infections, contaminated medical products, or injuries involving plant material, usually in immunocompromised patients.

The patient presented with <strong>1 day of confusion and fever</strong>. His history included heart failure with reduced ejection fraction, chronic kidney disease, diabetes, May-Thurner syndrome, and a recent hospitalization for streptococcal bacteremia and sepsis requiring temporary hemodialysis. On arrival, he was <strong>febrile, hypoxic, tachycardic, and hypotensive</strong>, requiring vasopressor support. Laboratory studies showed <strong>leukocytosis with neutrophilia</strong>, mild kidney dysfunction, and elevated inflammatory markers. CT imaging and transthoracic echocardiogram did not reveal a clear source of infection or endocarditis.

Despite initial evaluation, he continued to have fevers, and after 48 hours, <strong>all blood culture sets grew gram-negative bacilli identified as a Pantoea species</strong>. This confirmed the cause of his septic shock.

The report emphasizes that <strong>human Pantoea infections are rare</strong>, and spontaneous infection in otherwise healthy adults is especially unusual. In immunocompetent adults, infection is more commonly associated with healthcare-related contamination, such as parenteral nutrition, intravenous medications, or transfusions.

The patient improved with <strong>IV cefepime for 3 days</strong> until repeat blood cultures became negative, followed by a <strong>10-day course of oral levofloxacin</strong>. The authors note that Pantoea is usually susceptible to multiple antibiotics, including cephalosporins, fluoroquinolones, carbapenems, and piperacillin/tazobactam.

Asset Subtitle

Sonali W. Paul

Meta Tag

Author List Antonio Smith, Roudi Bachar, Shawn Gill, Sonali W. Paul

Category Clinical Vignettes

Concept Pantoea

Concept Bloodstream Infection

Concept Septic Shock

Concept Antibiotic susceptibility

Concept Parenteral Product Contamination

Distinguished Non-Finalist

Presenter Organization Indiana University

Presenting Author Sonali W. Paul

Track Adult

Keywords

Pantoea spp.

septic shock

gram-negative bacilli

immunocompetent man

bloodstream infection

bacteremia

fever and confusion

cefepime

levofloxacin

rare infection

Pantoea

Bloodstream Infection

Septic Shock

Antibiotic susceptibility

Parenteral Product Contamination