International Journal of Medical Science and Research

authors
Debomallya Bhuyan, Kunal Bhowmik, Mesashebha Rupsi, Arijit Kumar Das

abstract
Comamonas testosteroni is a rare human pathogen with only 52 documented cases till date. Among them, 13 cases reported the isolation of organism from peritoneal fluid, 12 of which were associated with an intra-abdominal source of infection. A definitive case of Spontaneous bacterial peritonitis caused by Comamonas testosteroni is yet to be reported. We are reporting a case of a 69 years old male, with no prior comorbidities, who presented with abdominal distension and pain for 4 weeks along with swelling of his legs. He was started on empirical therapy for spontaneous bacterial peritonitis owing to a high degree of suspicion. His liver function tests and imaging studies were suggestive of decompensated chronic liver disease with no foci of infection. Peritoneal fluid analysis confirmed the diagnosis of spontaneous bacterial peritonitis. He did not respond to cefotaxime and his condition worsened, developing encephalopathy. Peritoneal fluid culture showed growth of Comamonas testosteroni, resistant to cefotaxime. Antibiotic was changed according to sensitivity report. After 3 days, repeat paracentesis confirmed the resolution of infection. Patient’s condition improved and he was eventually discharged. This case highlights the possibility of uncommon pathogens causing SBP and the resistance of such pathogens to commonly advocated empirical therapy.