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case_images: Strain culture identification clinical examination (A) Colony and microscopical characteristics of P. dispersa. (B) The texture of both lungs was increased, disordered and blurred, and the shadow of upper mediastinum was widened. (C) The left lobe of the liver shows enhanced echogenicity in the parenchyma, considering the possibility of fatty infiltration. (D) Mass spectrometry identification, compared with Pantoea dispersa UR1131_1_10ERL strain score of 2.037. (E) The phylogenetic tree analysis. The bacterial isolate was compared with 16S rDNA of other Pantoea isolates.
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case_images: PMC11797003_01_IDR-18-661-g0001.jpg
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case_images: Blood culture results indicated that gram-negative bacteria were detected, with the emergence of white, smooth and mucoid colonies observed on the blood agar plate 24 hours later (Figure 1A). X-ray revealed increased lung texture, disorder, blurring, with floc flaky fuzzy shadow in both lung fields, indicating X-ray manifestations of pneumonia (Figure 1B). Ultrasonography indicated that the left medial lobe of liver enhanced the echo area, considering the possibility of fat infiltration (Figure 1C). Biotyper system and next-generation sequencing identification confirmed that the causative bacterium was P. dispersa. (Figure 1D and E) The results of the antimicrobial susceptibility test indicated that the pathogen was sensitive to ampicillin, cefazolin, cefuroxime, ceftazidime, cefepime, aztreonam, imipenem, meropenem, gentamicin, amikacin and tobramycin. Based on these sensitivity results, meropenem was continued, with the dosage adjusted to 20mg/kg iv drip q8h.