Case Report
Asymptomatic Bacteriuria Caused by Chromobacterium
violaceum in an Immunocompetent Adult
Narayan Dutt Pant,
1
Manisha Sharma,
1
and Saroj Khatiwada
2
1
Department of Microbiology, Grande International Hospital, P.O. Box 11796, Dhapasi, Kathmandu, Nepal
2
CIST College, Kathmandu, Nepal
Correspondence should be addressed to Narayan Dutt Pant; ndpant1987@gmail.com
Received 27 August 2015; Revised 20 September 2015; Accepted 21 September 2015
Academic Editor: Florian Talhammer
Copyright © 2015 Narayan Dutt Pant et al. Tis is an open access article distributed under the Creative Commons Attribution
License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly
cited.
Because of increasing antimicrobial resistance, the treatment of the asymptomatic bacteriuria is not considered except in specifc
circumstances like during pregnancy or before invasive urologic procedures. We are reporting a frst case of asymptomatic
bacteriuria caused by Chromobacterium violaceum in a 16-year-old male. With the reporting of the C. violaceum which is notorious
for its high propensity for hematogenous dissemination causing fatal sepsis (with reported mortality rate up to 65–80%) if prompt
proper treatment is not given, as causative agent of asymptomatic bacteriuria, it is recommended to treat the asymptomatic
bacteriuria caused by this organism.
1. Introduction
Asymptomatic bacteriuria is the presence of a signifcant
number of bacteria in the sample of properly collected urine
from a person with no signs of urinary tract infection [1].
Its prevalence varies according to the age, sex, sexual activ-
ity, and presence of abnormalities related to genitourinary
tract. Te causative organisms are diverse and may include
Enterobacteriaceae, Pseudomonas aeruginosa, Enterococcus
species, and group B Streptococcus with Escherichia coli being
the most common organism responsible [2]. Urinary tract
infection caused by Chromobacterium violaceum has been
rarely reported [3]. No cases of asymptomatic bacteriuria
caused by this organism have been reported yet in the world
literature and no cases of infection caused by Chromobac-
terium violaceum have been reported from Nepal. Here, we
are reporting a case of asymptomatic bacteriuria caused by
Chromobacterium violaceum in an immunocompetent adult
of 16 years. To the best of our knowledge, it is the frst case
in which C. violaceum was identifed as the cause of asymp-
tomatic bacteriuria. Current guidelines suggest screening and
treatment of asymptomatic bacteriuria only in specifc cir-
cumstances like during pregnancy or before invasive urologic
procedures [4]. Because of increasing antimicrobial resis-
tance problem, the patients with asymptomatic bacteriuria
should not be treated unless there is evidence of potential
beneft [2]. With the reporting of the highly virulent organism
like Chromobacterium violaceum which has high propensity
of hematogenous dissemination causing fatal sepsis with
reported mortality rate up to 65–80% [5], as the causative
agent of asymptomatic bacteriuria, it is recommended to treat
the asymptomatic bacteriuria caused by this organism.
2. Case Report
A 16-year-old male attended the emergency department of
a tertiary care hospital in Kathmandu, Nepal, in July 2015,
with chief complaint of acute lower right abdominal pain.
He has no past history of similar symptom but had a history
of recurrent urinary tract infection in childhood and there
were no urogenital tract abnormalities in the patient. He had a
history of playing football and dancing in a feld during a pic-
nic, about two weeks before. By the time the patient reached
the hospital, the symptom subsided spontaneously without
any treatment. Afer physical examination the necessary
Hindawi Publishing Corporation
Case Reports in Medicine
Volume 2015, Article ID 652036, 4 pages
http://dx.doi.org/10.1155/2015/652036