目的 紫色色杆菌（C. violaceum）感染临床表现缺乏特异性，早期识别存在一定难度，儿童患者更为罕见，本文旨在提高临床医师对该病的认识，并丰富全球病例资料。方法 对2012年1月至2021年12月期间收治的4例C. violaceum感染患儿的相关资料进行回顾性分析及报道。结果 4例C. violaceum感染患儿均为男性，系海南省原住民。平均发病年龄（2.50±3.07）岁，发病时间均集中于热带夏季；中位住院时间41.00（12.00~50.16）d，所有患儿均以发热为主要全身症状，3例表现为肺炎合并蜂窝织炎/脓肿形成，1例为肠炎表现，且4例患儿均存在炎症指标升高。病原学诊断通过细菌培养和高通量测序确认。药敏试验显示该菌对碳青霉烯类、氨基糖苷类和喹诺酮类敏感，对青霉素及多数头孢菌素类耐药。随访期间，1例患儿在出院10个月后因脓毒性休克死亡，另1例出现远期复发，提示可能存在慢性隐匿性感染。结论 C. violaceum感染表现形式多样，体液病原学培养对于明确诊断具有至关重要的意义。C. violaceum对青霉素类和头孢菌素类抗生素普遍耐药，药敏试验结果有助于指导治疗，但该疾病存在远期复发及致死风险，临床需提高警惕并加强随访。

Objective Chromobacterium violaceum (C. violaceum) infection presents with non-specific clinical manifestations, posing challenges for early identification—particularly in pediatric populations, where cases are extremely rare. This study aims to enhance clinicians’ awareness of pediatric C. violaceum infection and expand the global repository of case data. Methods A retrospective analysis and report were conducted on the relevant data of 4 children with C. violaceum infection admitted from January 2012 to December 2021. Results All 4 patients were male native residents of Hainan Province. The mean age at onset was (2.50±3.07) years, with all cases occurring during the tropical summer season. The median length of hospital stay was 41.00 (12.00-50.16) days. Fever was the predominant systemic symptom in all patients, 3 cases presented with pneumonia complicated by cellulitis/abscess formation, while 1 case manifested as enteritis. Elevated inflammatory markers were observed in all 4 patients. Etiological diagnosis was confirmed via bacterial culture and high-throughput sequencing. Antimicrobial susceptibility testing demonstrated susceptibility to carbapenems, aminoglycosides, and quinolones, but resistance to penicillins and most cephalosporins. During follow-up, 1 patient died of septic shock 10 months post-discharge, and another experienced late recurrence, suggesting the potential for chronic latent infection. Conclusion C. violaceum infection exhibits diverse clinical presentations. Pathogen culture of body fluids is critical for definitive diagnosis. While C. violaceum is universally resistant to penicillins and cephalosporins, antimicrobial susceptibility testing results are valuable for guiding treatment. Given the risks of late recurrence and mortality, clinicians should maintain vigilance and implement rigorous long-term follow-up for affected pediatric patients.