Chromobacterium violaceum Septicemia in a Paediatric Patient: Diagnostic and Therapeutic Challenges

Background: Chromobacterium violaceum, a rare Gram-negative bacillus, is found in tropical and subtropical soils and stagnant water. Human infections, though uncommon, are often severe and rapidly progress to septicaemia with high mortality. Diagnosing C. violaceum infections in paediatric cases is challenging due to their clinical overlap with other bacterial and viral infections. Methods: Blood and tissue cultures were analysed using automated VITEK 2 and conventional biochemical tests, which identified C. violaceum and guided the antimicrobial therapy. Results: Persistent fever and necrotic lesions suggested bacterial sepsis rather than a viral cause. Blood and tissue cultures revealed C. violaceum, sensitive to aztreonam, gentamicin, imipenem, meropenem, chloramphenicol, ciprofloxacin, and cotrimoxazole. The patient was successfully treated with meropenem, cotrimoxazole, and gentamicin over three weeks, resulting in clinical improvement and discharge. Conclusion: This case highlights the diagnostic challenges in distinguishing C. violaceum infections from other pathogens. Early identification through automated VITEK 2 and sensitivity testing facilitated effective treatment, underscoring the importance of considering C. violaceum in septic cases with necrotic skin lesions after water exposure in endemic areas. Prompt diagnosis and targeted therapy are essential for managing this life-threatening infection.