Hafnia alvei pneumonia: a rare cause of infection in the multimorbid or immunocompromised

BMJ Case Rep. 2020 Dec 31;13(12):e237061. doi: 10.1136/bcr-2020-237061.

Abstract

Hafnia alvei is a rare, poorly understood commensal bacterium which has, on occasion, been shown to infect humans. We present two cases. The first patient presented with a 1-week history of dyspnoea, pleurisy and a productive cough, and the second with a prodrome of fatigue and night sweats. The former had a history of severe chronic obstructive pulmonary disease and the latter had a history of Crohn's disease. Both patients had underlying comorbidities and immunosuppression, but differed in presentation, radiological findings and recovery. This case series aims to remind readers of the broad differential of pathogens that can lead to disease in the immunocompromised and that one should not dismiss atypical cultured bacteria as commensal too hastily.

Keywords: infections; pneumonia (infectious disease); pneumonia (respiratory medicine); respiratory system.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Aged
  • Amoxicillin-Potassium Clavulanate Combination / therapeutic use*
  • Anti-Bacterial Agents / therapeutic use
  • Ciprofloxacin / therapeutic use*
  • Clarithromycin / therapeutic use*
  • Comorbidity
  • Crohn Disease / complications
  • Enterobacteriaceae Infections / diagnosis*
  • Enterobacteriaceae Infections / drug therapy*
  • Enterobacteriaceae Infections / epidemiology
  • Female
  • Hafnia alvei / isolation & purification*
  • Humans
  • Immunocompromised Host
  • Male
  • Pneumonia, Bacterial / diagnosis*
  • Pneumonia, Bacterial / drug therapy*
  • Pneumonia, Bacterial / epidemiology
  • Pulmonary Disease, Chronic Obstructive / complications
  • Rare Diseases / epidemiology
  • Treatment Outcome
  • Young Adult

Substances

  • Anti-Bacterial Agents
  • Ciprofloxacin
  • Amoxicillin-Potassium Clavulanate Combination
  • Clarithromycin