# Unveiling the Uncommon: Roseomonas gilardii Bacteremia in a 10-Month Infant Presenting With Febrile Seizure

## TL;DR

A 10-month-old healthy infant had a rare infection from Roseomonas gilardii, which was linked to febrile seizures and successfully treated with antibiotics.

## Contribution

Reports a rare case of R. gilardii bacteremia in an immunocompetent infant, highlighting diagnostic and treatment implications.

## Key findings

- R. gilardii was isolated from a non-immunocompromised infant with febrile seizures.
- The VITEK® 2 Compact system enabled accurate identification of the rare pathogen.
- Ceftriaxone successfully treated the infection with no reported complications.

## Abstract

Roseomonas gilardii (R. gilardii), a Gram-negative coccobacillus, is an opportunistic pathogen most commonly isolated from immunocompromised children, especially those with underlying malignancies. In this case report, we present a non-immunocompromised 10-month-old infant diagnosed with R. gilardii bacteremia. Febrile seizures are a common neurological presentation in young children and are often associated with underlying infections such as bacteremia. While pathogens like Staphylococcus aureus and Salmonella species are commonly implicated, a proportion of cases remain without an identified causative organism. Although R. gilardii is typically associated with immunocompromised states, in this case, it was isolated from a previously healthy child. The primary clinical features included recurrent seizures, thrombocytopenia, and mild hearing loss. The isolation of R. gilardii in an immunocompetent infant is exceptionally rare, making this report clinically significant. The organism was identified using the VITEK® 2 Compact system (bioMérieux, Marcy l’Étoile, France), which enables rapid and accurate identification of rare, fastidious, or atypical organisms like R.gilardii by utilizing an extensive biochemical database and automated card-based technology, further enhancing diagnostic precision where conventional methods may be inconclusive. Antibiotic susceptibility testing showed sensitivity to ceftazidime, ceftriaxone, cefoperazone-sulbactam, cefepime, aztreonam, imipenem, meropenem, amikacin, gentamicin, ciprofloxacin, and levofloxacin. The patient was successfully treated with ceftriaxone. Although the mortality rate associated with Roseomonas species infections is low, this report highlights the importance of microbiologicalawareness, accurate identification, and appropriate antimicrobial therapy in pediatric cases involving rare pathogens. This is particularly important in pediatric and immunocompetent patients, where timely and accurate identification of unusual pathogens can significantly influence clinical decisions and outcomes.