Case Report

Infective Spondylitis with Epidural Abscess Formation Caused by Roseomonas mucosa: A Case Report and Literature Review

Table 1

Summary of reported infection cases caused by Roseomonas mucosa in the literature.

ReferenceAge/sexInfectionUnderlying disease/risk factorsIdentificationDrug resistanceTreatmentOutcome

Dé et al., 2004 [23]21/FBacteraemiaLeukaemia16S rRNA gene sequencingn.d.Removed CVC
IV LFX ⟶ oral LFX + AMC
IV IPM + VCM
Resolved
Dé et al., 2004 [23]65/MBacteraemiaLymphoma16S rRNA gene sequencingn.d.Various antibioticsResolved
Dé et al., 2004 [23]54/MBacteraemiaLeukaemia16S rRNA gene sequencingn.d.IPM + VCM ⟶ FEP + VCMResolved
Christakis et al., 2006 [16]39/MBacteraemiaAcute myelogenous leukaemia with neutropenic stateIdentified as Roseomonas sp. by RapidID NF PLUS
Misidentified as Methylobacterium mesophilicum by RapidID NF PLUS
Identified as R. mucosa by 16S rRNA gene sequencing
R: CAZ, AZT, CTX, TZP, TCC, and TMP-SMX
S: CFX, GM, TM, IPM, MEM, LFX, gatifloxacin, TE, AMK, FEP, and C
AMK + TZP for 10 DsResolved
Elshibly et al., 2005 [24]42/MBacteraemiaDiffuse large B-cell non-Hodgkin’s lymphoma16S rRNA gene sequencingR: ABPC, AZT, CTX, CAZ, CXM, CFX, AMC, MEM, TZP, TMP, and IPM
S: AMK, colomycin, GM, NET, and TM
TZP + GM ⟶ TEC + TZP + GMResolved
Sipsas et al., 2006 [25]40/MSeptic arthritisRheumatoid arthritis receiving infliximab therapy16S rRNA gene sequencingR: benzylpenicillin, TZP, FOX, CRO, and CAZ
S: CM, IPM, TE, DO, CFX, AMK, and GM
D 1–3: IV CRO
D 4–60: oral CFX
Resolved
Bard et al., 2010 [26]18/MBacteraemiaMultiple episodes of urinary tract infection and bacteraemia16S rRNA gene sequencingR: ABPC, CEZ, CAZ, CRO, TZP, and TMP-SMX
S: AMK, CFX, GM, IPM, LFX, MEM, and TM
VCM + CRO ⟶ CFX for 10 DsResolved
Boyd et al., 2012 [18]19/MPeritonitisHIV + ESRD with PDMisidentified as Ochrobactrum anthropi and Acinetobacter lwoffii by the VITEK 2 automated system
Misidentified as Methylobacterium mesophilicum by the API 20 NE system
Identified as R. mucosa by 16S rRNA gene sequencing
R: TZP, CAZ, and TMP-SMX
S: AMK, CRO, CFX, LFX, GM, IPM, MEM, and FEP
D 1–14: IP/IV CAZ + VCM
D 14–35: IP CFX + GM + VCM
D 35–49: IP CRO
PD failed; long-term haemodialysis commenced
Maraki et al., 2013 [27]54/FEpidural abscessInstrumented posterior lumbar interbody fusionMisidentified as R. gilardii by the VITEK 2 automated system
Identified as R. mucosa by 16S rRNA gene sequencing
R: beta-lactams (except CTX), FO, and colistin
S: carbapenems, aminoglycosides, fluoroquinolones, TEs, TGC, C, MNO, and TMP-SMX
Surgical debridement
D 1–24: IV VCM + oral rifampin
D 25–81: MEM
Resolved
Al-Anazi et al., 2013 [28]41/FBacteraemiaT-lymphoblastic lymphomaIdentified as Roseomonas by the VITEK 2 and the Microseq 500 16S rDNA bacterial identification kit
Identified as R. mucosa by 16S rRNA gene sequencing
R: PIP, TZP, and all cephalosporins
S: IPM, GM, AMK, and CFX
Removed CVC
D 1–4: IV TZP
D 4–14: IV IPM + AMK
CFX
Resolved
Michon et al., 2014 [17]3/n.d.BacteraemiaB-lineage acute lymphoblastic leukaemia16S rRNA gene sequencingR: TZP and IPM
S: AMK
D 1–4: TZP
D 4–7: IPM + AMK
D 7–14: oral CFM
Resolved
Matsukuma et al., 2014 [14]61/MPeritonitisDiabetic nephropathy and receiving PD for ESRD16S rRNA gene sequencingR: cephalosporins, including CAZ
S: GM, CFX and MEM
D 1–3: IP CEZ + AMK
D 4–6: IP CAZ
D 7–28: IP CFX
Resolved, changed to haemodialysis
Kim et al., 2015 [11]74/MInfective spondylitis with bacteraemiaVertebroplasty for compression fractures and laminectomy for spinal stenosisMisidentified as R. gilardii by the VITEK 2 automated system
Identified as R. mucosa by 16S rRNA gene sequencing
R: CFX, GM, and PIP
S: carbapenems, CAZ, TIC, and TM
D 1–7: IV CEZ
D 8–15: CAZ
1 month later: received total corpectomy + IV CAZ for 6 weeks
Resolved
Kim et al., 2016 [29]84/FBacteraemiaCommon bile duct obstructionMisidentified as R. gilardii by the VITEK 2 automated system
Identified as R. mucosa by 16S rRNA gene sequencing
R: ABPC and CAZ
S: aminoglycosides, carbapenems, fluoroquinolones, and CTX
CTX + METResolved
Kim et al., 2016 [29]17/MBacteraemiaAcute myeloid leukaemiaMisidentified as R. gilardii by the VITEK 2 automated system
Identified as R. mucosa by 16S rRNA gene sequencing
R: ABPC and CAZ
S: aminoglycosides, carbapenems, fluoroquinolones, and CTX
CAZ + aminoglycoside ⟶
VCM + carbapenem
Resolved
Bhende et al., 2017 [30]74/MEndogenous endophthalmitisDM16S rRNA gene sequencingn.d.D 1: intravitreal injection of CAZ + oral CTX + topical moxifloxacin + TM
D 2: intravitreal injection of VCM + CAZ
Received vitreous surgery + intravitreal CAZ
Postoperation: oral CFX + moxifloxacin + TM drops for 5 Ds
Resolved
Abu Choudhury et al., 2017 [19]53/MBacteraemiaPeripheral intravenous catheter insertionIllumina Nextera
XT and sequenced via the Illumina HiSeq 2000
n.d.CephalosporinNo systemic infection
Diesendorf et al., 2017 [31]n.d.Acute pulpitisn.d.MALDI-TOF mass spectrometryR: ABPC, ABPC/SBT, PIP, TZP CEZ, CXM, CAZ, and FO
S: CRO, IPM, MEM, GM, TM, AMK CFX, TMP-SMX, TE, TGC, and polymyxin B
n.d.n.d.
Kimura et al., 2018 [32]9/MBacteraemiaFebrile neutropenia caused by chemotherapy for cerebellar medulloblastoma16S rDNA sequencingR: PIP, AZT, and CAZ
S: carbapenems, aminoglycosides, MNO, fluoroquinolones, and TMP-SMX
MEMResolved
Shao et al., 2019 [10]44/FInfective endocarditisSystemic lupus erythematosusMisidentified as R. gilardii by the VITEK 2 automated system
Identified as R. mucosa by 16S rRNA gene sequencing
R: TZP, ABPC, CAZ, FEP, and colistin
S: AMK, GM, LFX, CFX, IPM, and MEM
D 4–7: VCM + TZP
D 8–11: TZP + LFX
D 12–25: MEM + AMK
Resolved
Beucler et al., 2020 [33]27/MPeritonitisVPS ventricular catheter for congenital hydrocephalusMALDI-TOF mass spectrometryR: TIC, TZP, CAZ, and FO
S: IPM, MEM, GM, AMK, and CFX
Removal of the shunt
D 1–9: CTX + linezolid
Resolved
Waris et al., 2021 [22]17/MMeningitisLeft temporal craniotomy for open fenestration of an arachnoid cystMisidentified as R. gilardii by the VITEK 2 automated system
Identified as R. mucosa by 16S rRNA gene sequencing
S: LFX and MEMD 1-2: IV MEM
D 2–8: oral LFX
D 10–12: IV MEM + VCM
D 12–47: IV MEM
Resolved
Roy et al., 2021 [15]65/FPeritonitisPD for ESRDMALDI-TOF mass spectrometryR: cephalosporin
S: GM
Removed the PD catheter IP GM for 3 weeksResolved
Spindel et al., 2022 [34]30/MPyogenic hepatic abscess with cardiac tamponadeDaily tobacco and marijuana smokingMALDI-TOF mass spectrometryS: CRO and CFXEmergent pericardiocentesis + hepatic and pericardial drains for 12 days
D 1–5: TZP + MET
D 5–40: CRO + MET
Resolved Metastatic hepatoid carcinoma noted 1 year later
Our case76/FInfective spondylitis with epidural abscessNerve block with local anaesthesia and radiofrequency coagulation in the lumbar spineMALDI-TOF mass spectrometryS: IPM, CRO, AMK, and CFXPartial laminectomy + debridement
D 1–7: FEP + VCM
D 5: Debridement
D 8–39: CRO
D 39–99: CFX
Resolved

ABPC: ampicillin; AMC: amoxicillin-clavulanic acid; AMK: amikacin; AZT: aztreonam; C: chloramphenicol; CAZ: ceftazidime; CEZ: cefazolin; CFM: cefixime; CM: clindamycin; CRO: ceftriaxone; CFX: ciprofloxacin; CTX: cefotaxime; CXM: cefuroxime; D: day; DM: diabetes mellitus; DO: doxycycline; ESRD: end-stage renal disease; FEP: cefepime; FO: fosfomycin; FOX: cefoxitin; GM: gentamicin; IP: intraperitoneal; IPM: imipenem; IV: intravenous; LFX: levofloxacin; MEM: meropenem; MET: metronidazole; MNO: minocycline; n.d.: not described; NET: netilmicin; PD: peritoneal dialysis; PIP: piperacillin; R: resistant; R. mucosa: Roseomonas mucosa; R. gilardii: Roseomonas gilardii; S: susceptible; SBT: sulbactam; TCC: ticarcillin-clavulanic acid; TEC: teicoplanin; TE: tetracycline; TGC: tigecycline; TIC: ticarcillin; TM: tobramycin; TMP-SMX: trimethoprim-sulfamethoxazole; TZP: piperacillin-tazobactam; VCM: vancomycin.