A clinical vignette on Raoultella planticola bacteremia

Raoultella planticola is a gram-negative bacillus. There are fewer than 35 reported infections with this organism in the literature. We describe a case of R. planticola bacteremia and osteomyelitis. A 25-year-old male was admitted to hospital with fatigue and fevers. His past medical history was remarkable for a mitochondrial cytopathy associated with gastrointestinal (GI) dysmotility. He was found to have R. planticola bacteremia. The source of his infection was not obvious but a bone scan of his feet (where the patient had chronic ulcers and worsening pain) showed chronic osteomyelitis (OM). He was treated with levofloxacin and cefazolin, following susceptibility testing, for 6 weeks. At the end of his treatment, his left heel pain markedly improved with resolution of fevers. To date, testing for immunocompromise has been negative. We present a novel case of R. planticola bacteremia and left heel OM in a patient with mitochondrial cytopathy who is not known to be immunocompromised.