Abstract:

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.

Key words: Chromobacterium violaceum, multiple abscesses, antimicrobial susceptibility testing, child