Rothia mucilaginosa Pneumonia in an Immunocompromised Patient

Abstract Rothia mucilaginosa is a gram-positive coccus recognized as an opportunistic pathogen capable of causing pneumonia in immunocompromised patients ( Antimicrob Agents Chemother . 1995;39:268–270). The organism is often resistant to fluoroquinolones and trimethoprim/sulfamethoxazole, agents routinely used as anti-infective prophylaxis in immunocompromised individuals ( Inf Dis Clin Pract . 2020;28:361–365; Infect Dis Now . 2021;51:228–235). Plasma next-generation sequencing (NGS) is increasing in clinical use to aid in diagnosis of infections in immunocompromised patients ( Infect Dis (Lond) . 2015;47:125–1299). A patient with advanced multiple myeloma was admitted with pneumonia. Plasma NGS initially suggested R. mucilaginosa , which was confirmed by cultures of bronchoalveolar lavage (BAL) fluid. Treatment with eravacycline led to clinical and radiographic resolution of pneumonia.