# An Unusual Case of Rhizobium radiobacter in Bronchoalveolar Lavage

## TL;DR

A rare case of Rhizobium radiobacter infection in a kidney disease patient in Pakistan highlights the need for careful diagnosis in immunocompromised individuals.

## Contribution

This is the first reported case of Rhizobium radiobacter in Pakistan and emphasizes its clinical significance in immunocompromised patients.

## Key findings

- Rhizobium radiobacter was isolated from bronchial washing in a patient with ESRD and SARS-CoV-2 infection.
- The patient showed improvement after treatment with antibiotics and antifungals.
- The case underscores the importance of timely evaluation in immunocompromised individuals.

## Abstract

Rhizobium radiobacter is a gram-negative bacterium that causes tumors in plants. In humans, it rarely causes infections. In most of the reported cases, the patient had long-standing indwelling devices or immunocompromised states. We present a case of a 49-year-old male with end-stage renal disease (ESRD) who is on twice-weekly maintenance hemodialysis, presenting with shortness of breath. With the initial diagnosis of community-acquired pneumonia and high-resolution computed tomography findings, bronchoscopy was performed, and bronchial washing was sent for pneumonia panel and cultures. The pneumonia panel was positive for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and the culture yielded growth of Rhizobium radiobacter and Aspergillus. Bronchial washing was also positive for COVID-19 infection. Antibiotics and antifungals were started, and the patient's inflammatory markers began to improve. To the best of our knowledge, this is the first case reported in Pakistan and depicts the importance of proper and timely evaluation of infections in immunocompromised patients.