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The patient noticed a leak in her Hickman catheter when infusing her nutrition. 24\u2009hours after a new catheter was replaced, the patient developed fevers, chills and weakness. She presented to the hospital with hypotension and tachycardia, meeting shock criteria. Blood cultures grew <jats:italic>P. ursingii,<\/jats:italic> and the diagnosis of septic shock was confirmed. Susceptibilities informed antibiotic coverage, and she ultimately improved within the next 48 hours.<\/jats:p>","DOI":"10.1136\/bcr-2023-258384","type":"journal-article","created":{"date-parts":[[2024,4,16]],"date-time":"2024-04-16T13:26:09Z","timestamp":1713273969000},"page":"e258384","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":9,"title":["Gram-negative sepsis caused by a rare pathogen <i>Phytobacter ursingii<\/i>"],"prefix":"10.1136","volume":"17","author":[{"given":"Samuel","family":"Choice","sequence":"first","affiliation":[{"name":"Internal Medicine, UI Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashten","family":"Sherman","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Holder","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, The University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine","family":"Harrington","sequence":"additional","affiliation":[{"name":"Infectious Diseases, UI Carver College of Medicine, Iowa City, Iowa, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2024,4,16]]},"reference":[{"key":"2025082710585389000_17.4.e258384.1","doi-asserted-by":"publisher","DOI":"10.1099\/ijsem.0.002477"},{"key":"2025082710585389000_17.4.e258384.2","unstructured":"Kubota H , Nakayama T , Ariyoshi T , et al . Emergence of Phytobacter Diazotrophicus carrying an Inca\/C 2 Plasmid Harbouring BLA NDM-1 in Tokyo. Japan mSphere 2023."},{"key":"2025082710585389000_17.4.e258384.3","doi-asserted-by":"crossref","DOI":"10.1128\/mra.00167-23","article-title":"Genomic identification of two Phytobacter Diazotrophicus isolates from a neonatal intensive care unit in Singapore","volume":"12","author":"Hon","year":"2023","journal-title":"Microbiol Resour Announc"},{"key":"2025082710585389000_17.4.e258384.4","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-022-04413-8"},{"key":"2025082710585389000_17.4.e258384.5","doi-asserted-by":"crossref","DOI":"10.1128\/spectrum.04022-22","article-title":"Diagnostic and therapeutic utility of positive Intravascular catheter tip cultures","volume":"10","author":"Ulrich","year":"2022","journal-title":"Microbiol Spectr"},{"key":"2025082710585389000_17.4.e258384.6","doi-asserted-by":"publisher","DOI":"10.1007\/s00203-007-0333-7"},{"key":"2025082710585389000_17.4.e258384.7","doi-asserted-by":"crossref","first-page":"1","DOI":"10.29245\/2689-9981\/2019\/4.1142","article-title":"Benefits and limitations of MALDI-TOF mass Spectrometry for the identification of microorganisms","volume":"2","author":"Rychert","year":"2019","journal-title":"J Infectiology"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2023-258384","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T17:59:03Z","timestamp":1756317543000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2023-258384"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4]]},"references-count":7,"journal-issue":{"issue":"4","published-online":{"date-parts":[[2024,4,16]]},"published-print":{"date-parts":[[2024,4]]}},"alternative-id":["10.1136\/bcr-2023-258384"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2023-258384","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4]]}}}