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Peer-reviewedCC BYCureus

Pandoraea Species Bacteremia in a Neonate: A Case Report

  • Syed Ali Raza Nasir1
  • Kinza Junaid1
  • Laraib Malik2
  • Ali Shabbir Hussain3
  1. 1Microbiology, Aga Khan University Hospital, Karachi, PAK
  2. 2Pediatric Infectious Diseases, Aga Khan University Hospital, Karachi, PAK
  3. 3Pediatrics and Child Health, Aga Khan University Hospital, Karachi, PAK
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Abstract

Pandoraea species are rare, nonfermenting Gram-negative bacilli that are increasingly recognized as opportunistic pathogens, particularly in patients with cystic fibrosis. They are often misidentified as Burkholderia or Ralstonia species and pose significant diagnostic and therapeutic challenges due to their variable resistance patterns and the absence of standardized susceptibility breakpoints. We report a case of a seven-day-old term, low-birth-weight neonate who presented with respiratory distress and features of sepsis. Blood cultures grew a nonfermenting Gram-negative organism, initially identified as Burkholderia cepacia. Further testing using automated identification systems confirmed Pandoraea species. The organism demonstrated reduced susceptibility to multiple empiric antibiotics, including meropenem and ceftazidime. In the absence of established interpretive criteria, antimicrobial therapy was guided by phenotypic susceptibility patterns and literature review, and treatment was modified to trimethoprim-sulfamethoxazole and levofloxacin. The patient showed gradual clinical improvement with resolution of clinical and laboratory markers of infection and was eventually discharged. This case highlights the importance of accurate identification of uncommon pathogens, awareness of their unique resistance profiles, and close interdisciplinary collaboration to guide management in the absence of standardized treatment guidelines.

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Cite

BibTeXRIS
BibTeX
@article{nasir2026pandoraea,
  title = {{Pandoraea Species Bacteremia in a Neonate: A Case Report}},
  author = {Syed Ali Raza Nasir and Kinza Junaid and Laraib Malik and Ali Shabbir Hussain},
  journal = {Cureus},
  year = {2026},
  month = sep,
  doi = {10.7759/cureus.117203},
  url = {https://europepmc.org/article/PMC/PMC13720938},
  note = {CC BY},
}
RIS
TY  - JOUR
TI  - Pandoraea Species Bacteremia in a Neonate: A Case Report
AU  - Syed Ali Raza Nasir
AU  - Kinza Junaid
AU  - Laraib Malik
AU  - Ali Shabbir Hussain
PY  - 2026
DA  - 2026/09/30
JO  - Cureus
DO  - 10.7759/cureus.117203
UR  - https://europepmc.org/article/PMC/PMC13720938
AB  - Pandoraea species are rare, nonfermenting Gram-negative bacilli that are increasingly recognized as opportunistic pathogens, particularly in patients with cystic fibrosis. They are often misidentified as Burkholderia or Ralstonia species and pose significant diagnostic and therapeutic challenges due to their variable resistance patterns and the absence of standardized susceptibility breakpoints. We report a case of a seven-day-old term, low-birth-weight neonate who presented with respiratory distress and features of sepsis. Blood cultures grew a nonfermenting Gram-negative organism, initially identified as Burkholderia cepacia. Further testing using automated identification systems confirmed Pandoraea species. The organism demonstrated reduced susceptibility to multiple empiric antibiotics, including meropenem and ceftazidime. In the absence of established interpretive criteria, antimicrobial therapy was guided by phenotypic susceptibility patterns and literature review, and treatment was modified to trimethoprim-sulfamethoxazole and levofloxacin. The patient showed gradual clinical improvement with resolution of clinical and laboratory markers of infection and was eventually discharged. This case highlights the importance of accurate identification of uncommon pathogens, awareness of their unique resistance profiles, and close interdisciplinary collaboration to guide management in the absence of standardized treatment guidelines.
SN  - 2168-8184
ER  -