Annals of Tropical Medicine and Public Health

CASE REPORT
Year
: 2012  |  Volume : 5  |  Issue : 4  |  Page : 360--361

Cutaneous abscess due to Chryseomonas luteola in a previously healthy adult


Kavita G Patil1, Shankar G Karadesai1, Parag V Hawaldar2,  
1 Department of Microbiology, J N Medical College, Nehru Nagar, Belgaum, Karanataka, India
2 Department of Surgery, J N Medical College, Nehru Nagar, Belgaum, Karanataka, India

Correspondence Address:
Kavita G Patil
Department of Microbiology, Jawaharlal Nehru Medical College and KLE Prabhakar Kore Hospital, Nehru Nagar, Belgaum, Karanataka - 590 010
India

Abstract

Chryseomanas luteola is non-fermenting gram-negative bacilli, which was previously known as Chromobacterium typhiflavum, CDC group Ve-1, Pseudomonas luteola, and Pseudomonas polytricha. The taxonomic status was resolved in 1987 with the placement of the organism into the new genus Chryseomonas having a single species named Chryseomonas luteola.



How to cite this article:
Patil KG, Karadesai SG, Hawaldar PV. Cutaneous abscess due to Chryseomonas luteola in a previously healthy adult.Ann Trop Med Public Health 2012;5:360-361


How to cite this URL:
Patil KG, Karadesai SG, Hawaldar PV. Cutaneous abscess due to Chryseomonas luteola in a previously healthy adult. Ann Trop Med Public Health [serial online] 2012 [cited 2020 Sep 18 ];5:360-361
Available from: http://www.atmph.org/text.asp?2012/5/4/360/102058


Full Text

 Introduction



Chryseomonas luteola or Pseudomonas luteola has cellular fatty acid composition, similar to pseudomonas and was formerly classified as CDC group Ve-1 by Tatum et al. [1] Strains of group Ve-1 were first classified as Pseudomonas luteola by Kodama et al. [2] However, these strain were oxidase-negative and showed no appreciable DNA - DNA relatedness to strains representing the major Pseudomonas rRNA hybridization groups. Hence, Holmes and co-workers considered it more appropriate to place the organism in a new genus and gave it the name Chryseomonas polytricha. Later, they reclassified the species in the genus Chryseomonas as C. luteola, because P. luteola was a senior subjective synonym of Chryseomonas polytricha. [3]

Chryseomonas luteola has been recognized as an uncommon cause of bacteremia and infections in patients with underlying diseases or in association with foreign body. We report a case of cutaneous abscess caused by Chryseomonas luteola in an apparently healthy individual with no underlying cause.

 Case Report



A 52-year-old man was admitted in surgery ward with complaint of swelling on medial aspect of right foot. There were no other symptoms. Patient was apparently alright 7 days back when he developed small swelling on the medial side of right foot close to medial malleolus, which gradually increased in size. There was no past history of trauma, fever, tuberculosis, diabetes mellitus, and hypertension. On examination, patient was afebrile, pulse was 72/min, respiratory rate was 16/ min, and blood pressure was 110/70 mmHg. On local examination, the swelling was 4 x 4 cm in size, tender, and the temperature over it was raised. The skin over the swelling had reddish-yellow discoloration and it was peeling off.

His investigations revealed that hemoglobin was 12.5 g/dl, total leukocyte count was 12,600/mm 3 with polymorphs 80%, platelets 2,60,000/mm 3 , ESR was 24, PCV was 36. Random blood sugar was 114 mg/dl. The other biochemical parameters were within normal limits. The HIV and HBsAg status was negative. The abscess was drained under aseptic precautions, and the pus was sent for culture.

The gram stain of pus sample showed plenty of pus cells and few gram-negative bacilli. The pus was cultured aerobically as well as anaerobically. After an overnight aerobic incubation, there was pure growth of small, dry, yellow pigmented colonies on blood agar and MacConkey agar, and the pigment improved on further incubation. The organism was gram-negative bacilli, motile, catalase-positive, oxidase-negative and did not show any change on Triple Sugar Iron Agar. It showed oxidative change on Glucose Hugh Liefson medium and fermentative change on mannitol Hugh Liefson medium. It hydrolyzed esculin. The organism was identified as Chryseomonas luteola and later confirmed by Micro Auto Scan 4 (Dade Behring, Siemans, USA). Anaerobic culture did not show any growth. Blood culture of the same patient did not show any growth. Antibiotic susceptibility test was performed by Kirby-Bauer disk diffusion method. The isolate was sensitive to amikacin, cephelexin, cefaperazone, amoxicillin clavulanic acid, ciprofloxacin, piperacillin, trimethoprim sulfamethoxazole, but resistant to ampicillin and cephadroxil.

 Discussion



Chryseomonas luteola is a saprophyte found in soil and water, and human infections caused by this organism are on a rise. Predisposing factors for infection include immunosuppressive conditions like use of corticosteroids, malignancy, and patients infected with HIV. It commonly causes septicemia in patients with indwelling vascular devices and peritonitis in patients with peritoneal dialysis catheters. Other infections described previously include meningitis, osteomyelitis, endocarditis, pneumonia, post-surgical complications. [4]

Although most of these reports were in individuals with one of the predisposing factors, there are very few documented cases of C. luteola infection in previously healthy adults. In previously healthy adults, it has been reported to cause facial cellulitis with bacteremia in one case and cutaneous abscess with bacteremia in another case. [5],[6] Our patient did not have fever or any other systemic manifestations neither there was any history of trauma or previous surgery. His pus revealed a pure growth of gram-negative bacilli with dry, yellow, wrinkled colonies, which clearly signifies its role as causative agent.

Although in previous reports C. luteola has shown resistance to trimethoprim sulfamethaxazole, narrow, and expanded spectrum cephalosporins, tetracycline, ampicillin, our isolate showed good sensitivity, suggesting it to be a community isolate. The patient responded well to the post-surgical antibiotic cover of amoxicillin - clavulanic acid and amikacin and was discharged after a week.

This case clearly suggests the role of C. luteola as a potential pathogen not only in patients with predisposing factors but also in previously healthy people. Hence, microbiologists need to be vigilant in detection of such organisms without ignoring it as a contaminant.

Also, in future, further research using molecular typing techniques needs to be done to define reservoirs and patterns of transmission of C. luteola.

References

1Tatum HW, Ewing WH, Weaver RE. Miscellaneous gram-negative bacteria. In: Lennette EH, Spaulding EH, Truant JP, editors. Manual of clinical microbiology. 2nd ed. Washington DC: American Society for Mirobiology; 1974. p. 270-94.
2 Kodama K, Kimura N, Komagata K. Two new species of Pseudomonas: P. oryzihabitans isolated from rice paddy and clinical specimens and P. luteola isolated from clinical specimens. Int J Syst Bacteriol 1985;35:467-74.
3 Holmes B, Steigerwalt AG, Weaver RE, Brenner DJ. Chryseomonas luteola comb. nov. and Flavimonas oryzihabitans gen. nov., comb. nov., Pseudomonas-like species from human clinical specimens and formerly known, respectively, as groups Ve-1 and Ve-2. Int J Syst Bacteriol 1987;37:245-50.
4 Chihab W, Alaoui A, Amar M. Chryseomonas luteola as a source of serious infections in a Moroccan university hospital. J Clin Microbiol 2004;42:1837-9.
5 Rastogi S, Sperber SJ. Facial cellulitis and Pseudomonas luteola bacteremia in an otherwise healthy patient. Diagn Microbiol Infect Dis 1998;32:303-5.
6 Dalamaga M, Karmaniolas K, Chavelas C, Liatis S, Matekovits H, Migdalis I. Pseudomonas luteola cutaneous abscess and bacteremia in a healthy man. Scand J Infect Dis 2004;36:495-7.