Mal J Med Health Sci 16(SP1): 41-43, Sept 2020 41 Malaysian Journal of Medicine and Health Sciences (eISSN 2636-9346) case report A Rare Case of Haemophilus parahaemolyticus Pneumonia Navin Kumar Devaraj 1 , Syafinaz Amin Nordin 2 1 Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor 2 Department of Medical Microbiology and Parasitology, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 43400 Serdang, Selangor ABSTRACT Pneumonia is a common lung infection. Common bacterial cause of this serious lung infection includes Streptococcus pneumoniae, Haemophilus influenzae and Mycoplasma pneumoniae. Haemophilus parahaemolyticus pneumonia is an uncommon cause of bacterial pneumonia, occurring mainly as an opportunistic pathogen in immunocompromised patients as in this case, diabetes mellitus. Therefore, this case report will look at a case of 49-year-old man who was diagnosed with this uncommon pathogen which was successfully eradicated with antibiotics. This case report will look at a case of 49 years old who was diagnosed with this uncommon pathogen which was successfully eradicated with antibiotics. Keywords: Pneumonia, Haemophilus parahaemolyticus, Good clinical acumen, Uncommon Corresponding Author: Navin Kumar Devaraj, MMed (Family Medicine) Email: knavin@upm.edu.my Tel: +6013-3105381 INTRODUCTION Pneumonia is a common lung infection having an incidence numbering millions of cases per year, with 3 million cases in United States of America alone. Common pathogens for community acquired pneumonia include Streptococcus pneumoniae, Haemophilus influenzae and Mycoplasma pneumoniae, Legionella species and respiratory viruses (1). A rare cause of bacterial pneumonia in human will be Haemophilus parahaemolyticus, which is a commensal bacterium of the upper respiratory tract. It can occasionally cause pharyngitis and very rarely subacute endocarditis (2,3). It as an opportunistic pathogen occurring mainly in immunocompromised patient. Literature about Haemophilus parahaemolyticus as a cause of bacterial pneumonia is scarce and therefore one such rare case of this will be reported here. CASE REPORT A 49-year-old man with underlying well controlled type 2 diabetes mellitus (latest HbA1c 6.2 % taken one month ago) and dyslipidaemia presented with dry cough for two weeks associated with low grade fever at a government health clinic. There was no sore throat or runny nose. Appetite was reduced which was accompanied by a weight loss of 2kg over the last two weeks. He had seen a private general practitioner one week ago where he was offered symptomatic treatment. However, his cough has worsened in severity especially at night, leading to his visit to the government health clinic. Physical examination including vital signs were normal. Respiratory examination showed the presence of crepitation over his right lower lung without any rhonchi. There were no enlarged lymph nodes. Abdominal examination was normal. Full blood count showed an increased white blood cell count of 17 x 10 9 /L with raised neutrophil count of 11 x 10 9 /L. Random blood sugar was 6.3 mmol/L. Chest X-ray showed consolidation over right lower zone as indicated by the arrow (Figure 1). A diagnosis of right lung lobar pneumonia was made. He was started on oral cefuroxime 250mg twice a day for 10 days. A few investigations were ordered including sputum for acid fast bacilli, sputum culture and sensitivity (including for Mycobacterium tuberculosis), Mantoux test and erythrocyte sedimentation rate. The sputum sample collection was done according to the guidelines as recommended by World Health Organisation including the first sample of day, non-touch technique and making sure that the sample collected was sputum and not saliva, among others. He was given an appointment in one week where