Autopsy and Case Reports
Autopsy and Case Reports
Article / Autopsy Case Report

Fatal pancreatic pseudocyst co-infected by Raoultella planticola: an emerging pathogen

Fernando Peixoto Ferraz de Campos, Tiago Borges Guimarães, Silvana Maria Lovisolo

Downloads: 35
Views: 1076


Raoultella planticola is an aerobic Gram-negative bacterium belonging to the Enterobacteriaceae family. Initially identified in the 1980s, its pathogenic potential was further recognized when the first case of bacteremia was reported. Since then, only a few infections caused by this pathogen have been described. Although considered an opportunistic agent, fatal outcomes are associated with the infection by this pathogen, since it is more prevalent among the patients with immunodeficiency. The authors report the case of a middle-aged man diagnosed with end-stage renal disease and alcoholic pancreatitis, who was admitted to the emergency department with septic shock. Physical examination disclosed peritoneal irritation and a laparotomy was undertaken. Purulent peritonitis was found as well as a retroperitoneal abscess, which was drained. The postoperative period was troublesome, and the patient died. The autopsy showed a ruptured, infected pancreatic cyst and purulent peritonitis, among other findings. The culture of the peritoneal fluid and two blood sample sets were positive for R. planticola. The authors call attention to the importance of this emerging pathogen associated with severe gastrointestinal infections.


Enterobacteriaceae Infections, Pancreatic Diseases, Peritonitis, Autopsy


1. Bagley ST, Seidler RJ, Brenner DJ. Klebsiella planticola sp. nov.: a new species of Enterobacteriaceae found primarily in nonclinical environments. Curr Microbiol. 1981;6(2):105-9.

2. Drancourt M, Bollet C, Carta A, Rousselier P. Phylogenetic analyses of Klebsiella species delineate Klebsiella and Raoultella gen. nov., with description of Raoultella ornithinolytica comb. nov., Raoultella terrigena comb. nov. and Raoultella planticola comb. nov. Int J Syst Evol Microbiol. 2001;51(Pt 3):925-32. PMid:11411716.

3. Monnet D, Freney J, Brun Y, Boeufgras JM, Fleurette J. Difficulties in identifying Klebsiella strains of clinical origin. Zentralbl Bakteriol. 1991;274(4):456-64. PMid:1863314.

4. Westbrook GL, O’Hara CM, Roman SB, Miller JM. Incidence and identification of Klebsiella planticola in clinical isolates with emphasis on newborns. J Clin Microbiol. 2000;38(4):1495-7. PMid:10747132.

5. Alves MS, Dias RC, de Castro AC, Riley LW, Moreira BM. Identification of clinical isolates of indole-positive and indolenegative Klebsiella spp. J Clin Microbiol. 2006;44(10):3640-6. PMid:16928968.

6. Monnet D, Freney J. Method for differentiating Klebsiella planticola and Klebsiella terrigena from other Klebsiella species. J Clin Microbiol. 1994;32(4):1121-2. PMid:8027329.

7. Kim SW, Kim JE, Hong YA, Ko GJ, Pyo HJ, Kwon YJ. Raoultella planticola peritonitis in a patient on continuous ambulatory peritoneal dialysis. Infection. 2015;43(6):771-5. PMid:25958102.

8. Alves MS, Riley LW, Moreira BM. A case of severe pancreatitis complicated by Raoultella planticola infection. J Med Microbiol. 2007;56(5):696-8. PMid:17446297.

9. Freney J, Fleurette J, Gruer LD, Desmonceaux M, Gavini F, Leclerc H. Klebsiella trevisanii colonisation and septicaemia. Lancet. 1984;1(8382):909. PMid:6143213.

10. Ershadi A, Weiss E, Verduzco E, Chia D, Sadigh M. Emerging pathogen: a case and review of Raoultella planticola. Infection. 2014;42(6):1043-6. PMid:24902523.

11. Yokota K, Gomi H, Miura Y, Sugano K, Morisawa Y. Cholangitis with septic shock caused by Raoultella planticola. J Med Microbiol. 2012;61(Pt 3):446-9. PMid:22096135.

12. Puerta-Fernandez S, Miralles-Linares F, Sanchez-Simonet MV, Bernal-Lopez MR, Gomez-Huelgas R. Raoultella planticola bacteraemia secondary to gastroenteritis. Clin Microbiol Infect. 2013;19(5):E236-7. PMid:23574552.

13. Li J, Lan R, Xiong Y, et al. Sequential isolation in a patient of Raoultella planticola and Escherichia coli bearing a novel ISCR1 element carrying blaNDM-1. PLoS One. 2014;9(3):e89893. PMid:24594606.

14. Freney J, Gavini F, Alexandre H, et al. Nosocomial infection and colonization by Klebsiella trevisanii. J Clin Microbiol. 1986;23(5):948-50. PMid:3711281.

15. Castanheira M, Deshpande LM, DiPersio JR, Kang J, Weinstein MP, Jones RN. First descriptions of blaKPC in Raoultella spp. (R. planticola and R. ornithinolytica): report from the SENTRY antimicrobial surveillance program. J Clin Microbiol. 2009;47(12):4129-30. PMid:19812278.

16. HuAY, Leslie KA, Baskette J, Elsayed S. Raoultella planticola bacteraemia. J Med Microbiol. 2012;61(Pt 10):1488-9. PMid:22820690.

17. González-González L, Álvarez-Otero J, Ferreiro JLL, Aguado JF. Cholangitis and bacteremia caused by Raoultella planticola. Med Clin. 2015;144(5):230-4. PMid:24994005.

18. Xu M, Xie W, Fu Y, Zhou H, Zhou J. Nosocomial pneumonia caused by carbapenem-resistant Raoultella planticola: a case report and literature review. Infection. 2015;43(2):245-8. PMid:25595510.

19. Salmaggi C, Ancona F, Olivetti J, Pagliula G, Ramirez GA. Raoultella planticola-associated cholangitis and sepsis: a case report and literature review. QJM. 2014;107(11):911-3. PMid:24733944.

20. Lee JH, Choi WS, Kang SH, et al. A case of severe cholangitis caused by Raoultella planticola in a patient with pancreatic cancer. Infect Chemother. 2012;44(3):210-2.

21. Teo I, Wild J, Ray S, Chadwick D. A rare case of cholecystitis caused by Raoultella planticola. Case Rep Med. 2012;2012:601641. PMid:22690225.

22. Olson DS Jr, Asare K, Lyons M, Hofinger DM. A novel case of Raoultella planticola urinary tract infection. Infection. 2013;41(1):259-61. PMid:22802099.

23. Koukoulaki M, Bakalis A, Kalatzis V, et al. Acute prostatitis caused by Raoultella planticola in a renal transplant recipient: a novel case. Transpl Infect Dis. 2014;16(3):461-4. PMid:24750300.

24. Wolcott R, Dowd S. Molecular diagnosis of Raoultella planticola infection of a surgical site. J Wound Care. 2010;19(8):329-32. PMid:20852504.

25. O’ Connell K, Kelly J, Niriain U. A rare case of soft-tissue infection caused by Raoultella planticola. Case Rep Med. 2010;2010:134086. PMid:20811592.

26. Kim SH, Roh KH, Yoon YK, et al. Necrotizing fasciitis involving the chest and abdominal wall caused by Raoultella planticola. BMC Infect Dis. 2012;12(1):59. PMid:22423899.

27. Zuberbuhler B, Abedin A, Roudsari A. A novel case of chronic conjunctivitis in a 58-year-old woman caused by Raoultella. Infection. 2014;42(5):927-9. PMid:24865691.

28. Tseng SP, Wang JT, Liang CY, Lee PS, Chen YC, Lu PL. First report of blaIMP-8 in Raoultella planticola. Antimicrob Agents Chemother. 2014;58(1):593-5. PMid:24145534.

29. Tang H-X, Wu A-W, Song J-L, Yang L, Chen D-Q, Lin Y-P. Extensively drug-resistant Raoultella planticola carrying multiple resistence genes including blaNDM-1. JMM Case Rep. 2014;1(3).

Publication date:

5773d7b35ce02afd4c000001 autopsy Articles
Links & Downloads

Autops Case Rep

Share this page
Page Sections