# Brevundimonas vesicularis sepsis in a 2-month-old infant in rural Gambia: a case report

## TL;DR

A 2-month-old infant in Gambia with a heart condition developed a rare infection caused by Brevundimonas vesicularis, which responded well to antibiotics.

## Contribution

This is the first reported case of B. vesicularis sepsis in an infant with congenital heart disease in rural Gambia.

## Key findings

- B. vesicularis was identified in a blood culture from a 2-month-old infant with sepsis and congenital heart disease.
- The bacterium was sensitive to all tested antibiotics, and the child improved after treatment with amoxicillin clavulanate and gentamicin.
- The case highlights the need for better surveillance and infrastructure to manage emerging pathogens in low-resource settings.

## Abstract

Brevundimonas vesicularis, a Gram-negative bacillus and non-lactose fermenter, is primarily found in both clinical and environmental samples. Although it rarely causes infections and is typically regarded as an opportunistic pathogen, it has been associated with cases of bacteremia, peritonitis, meningitis, arthritis, and skin infections. While there is high variability among cases, depending on site, infection severity, patient age, immune status, and geographic location, most cases occur in patients with underlying congenital conditions and immunocompromised individuals, which could represent an emerging global concern, particularly in low- and middle-income countries.

We present a 2-month-old African male infant who exhibited signs of sepsis and cyanotic congenital heart disease. The blood culture identified Brevundimonas vesicularis. Antimicrobial susceptibility testing was performed, and the bacterium was found to be sensitive to all the antibiotics evaluated. We treated the child with the empiric first-line antibiotics intravenous amoxicillin clavulanate and intravenous gentamicin for 6 days. The child improved and was referred for an echocardiogram and cardiology review.

This report details a rare case of B. vesicularis sepsis in a 2-month-old infant with congenital heart disease in the Gambia. B. vesicularis is an emerging pathogen linked to opportunistic infections in patients with congenital disorders and immunocompromised individuals. This report highlights comorbidities as key risk factors for acquiring B. vesicularis infection, underscoring the need for a multidisciplinary and holistic approach to improve clinical outcomes. Therefore, an improved surveillance system, skilled personnel, and adequate infrastructure are essential for early detection, accurate diagnosis, and effective management based on local antibiogram data, to control antibiotic resistance.