Case Report
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Mar 26, 2023; 11(9): 2002-2008
Published online Mar 26, 2023. doi: 10.12998/wjcc.v11.i9.2002
Children with infectious pneumonia caused by Ralstonia insidiosa: A case report
Shuang-Zhu Lin, Mei-Jia Qian, Yan-Wei Wang, Qian-Dui Chen, Wan-Qi Wang, Jia-Yi Li, Rui-Tong Yang, Xin-Yao Wang, Chun-Yu Mu, Kai Jiang
Shuang-Zhu Lin, Mei-Jia Qian, Kai Jiang, Diagnosis and Treatment Center for Children, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, Jilin Province, China
Yan-Wei Wang, Department of Imaging, Affiliated Hospital of Changchun University of Chinese Medicine, Changchun 130021, Jilin Province, China
Qian-Dui Chen, Rui-Tong Yang, Xin-Yao Wang, College of Integrated Chinese and Western Medicine, Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China
Wan-Qi Wang, Jia-Yi Li, Chun-Yu Mu, College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun 130117, Jilin Province, China
Author contributions: Lin SZ and Qian MJ are the attending doctors at the Diagnosis and Treatment Center for Children, Affiliated Hospital of Changchun University of Chinese Medicine, and provided this case; Wang YW and Chen QD reviewed the literature, and wrote and revised the manuscript; Wang WQ, Yang RT and Wang XY compiled the literature review, conducted the preliminary translation of the report and the subsequent submission; Jiang K provided guidance on the article; and all authors issued final approval for the version to be submitted.
Informed consent statement: We have obtained informed consent from the parents of the child.
Conflict-of-interest statement: All the authors report no relevant conflicts of interest for this article.
CARE Checklist (2016) statement: We have read and followed the CARE Checklist (2016) to prepare this report.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Jiang, MD, Chief Physician, Professor, Diagnosis and Treatment Center for Children, Affiliated Hospital of Changchun University of Chinese Medicine, No. 1478 Gongnong Road, Chaoyang District, Changchun 130021, Jilin Province, China. 2835221172@qq.com
Received: November 8, 2022
Peer-review started: November 8, 2022
First decision: November 25, 2022
Revised: December 2, 2022
Accepted: February 21, 2023
Article in press: February 21, 2023
Published online: March 26, 2023
Abstract
BACKGROUND

Ralstonia is a Gram-negative non-fermentative bacterium widespread in nature, and includes four species, Ralstonia pickettii, Ralstonia solanacearum, Ralstonia mannitolilytica, and Ralstonia insidiosa, which were proposed in 2003. Ralstonia is mainly found in the external water environment, including municipal and medical water purification systems. This bacterium has low toxicity and is a conditional pathogen. It has been reported in recent years that infections due to Ralstonia are increasing. Previous studies have shown that most cases of infection are caused by Ralstonia pickettii, a few by Ralstonia mannitolilytica, and infections caused by Ralstonia insidiosa are rare.

CASE SUMMARY

A 2-year-old Chinese child suffered from intermittent fever and cough for 20 d and was admitted to hospital with bronchial pneumonia. Bronchoscopy and alveolar lavage fluid culture confirmed Ralstonia insidiosa pneumonia. The infection was well controlled after treatment with meropenem and azithromycin.

CONCLUSION

Ralstonia infections are increasing, and we report a rare case of Ralstonia insidiosa infection in a child. Clinicians should be vigilant about Ralstonia infections.

Keywords: Children, Infections, Ralstonia insidiosa, Pneumonia, Treatment, Case report

Core Tip: Ralstonia is a rare type of conditionally pathogenic bacterium found in nature, and its infection incidents have been increasing in recent years. We describe a 2-year-old male baby, who was diagnosed with Ralstonia insidiosa infection after culture of alveolar lavage fluid. The infection was controlled with a combination of two antibiotics. Our report adds to the case reports of rare Ralstonia insidiosa infections and warns doctors to be aware of this rare infection.