The University of Toledo Translation Journal of Medical Sciences 
Infectious Diseases Abstract, Department of Medicine Research Symposium UTJMS 2023 May 5; 11(1):e1-e1 

Cellulosimicrobium Bacteremia in a Patient 
With Small Cell Lung Cancer: Emergence 
of a New Gram-Positive Branching Rod 
Victoria Soewarna1*, Meghan Deutsch1, Basmah Kahlil, MD1, Haroon Shah, DO1, Joel Kammeyer, MD, MPH1 

1Division of Infectious Diseases, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 

*Corresponding author: Victoria.soewarma@rockets.utoledo.edu

Published: 05 May 2023 

A 64-year-old male with a history of esophageal adenocarcinoma, placement of a spinal stimulator, 
cervical and lumbar fusions, and stage IV small cell lung cancer on palliative chemotherapy with 
carboplatin and etoposide, presented to the hospital with neutropenic fever. He reported intermittent 
fevers prior to admission and had episodic fevers with a Tmax = 38.2° throughout his hospitalization. 
Ocular examination revealed no evidence of endophthalmitis or keratitis. Oral examination revealed no 
tongue ulcers, and an abdominal examination revealed no tenderness. He was empirically placed on 
cefepime and vancomycin. Chest x-ray revealed multifocal pneumonia. His neutropenia recovered on 
hospital day 2, but his fevers persisted and were attributed to pneumonia and possible bacteremia. On 
hospital day 3, initial blood cultures revealed a branching gram-positive rod. The initial suspicion for a 
causative agent was Nocardia or Actinomyces; vancomycin was discontinued and intravenous 
trimethoprim-sulfamethoxazole and meropenem were initiated. The blood cultures were identified as 
Cellulosimicrobium species on hospital day 11; his meropenem was discontinued and vancomycin was 
initiated. A transthoracic echocardiogram did not reveal endocarditis, and the patient was discharged on 
hospital day 24 and completed a 14-day total course of vancomycin. Cellulosimicrobium spp. is an 
emerging pathogen that has been described as an opportunistic infection in immunocompromised hosts. 
This case highlights Cellulosimicrobium spp. as an opportunistic pathogen, especially in 
immunocompromised individuals as a source of secondary bacteremia. It emphasizes that 
Cellulosimicrobium spp. should be considered in a differential diagnosis as it is an emerging pathogen 
with increasing prevalence. 

https://dx.doi.org/10.46570/utjms.vol11-2023-759 

https://dx.doi.org/10.46570/utjms.vol11-2023-759
mailto:Victoria.soewarma@rockets.utoledo.edu