Detection of Pantoea ananatis in cerebrospinal fluid: a case report of central nervous system infection after craniotomy

Pantoea ananatis(P. ananatis) is a facultative anaerobic gram-negative bacillus in the Enterobacteriaceae. It is commonly found in plants, soil, and water, rarely causing human infection. Here, we present the first cerebrospinal fluid infection case caused by P. ananatis in humans. To our knowledge, this is the first reported case of central nervous system infection caused by P. ananatis. A 49-year-old male patient presented with acute traumatic left parietal subdural hematoma and subarachnoid hemorrhage, for which he underwent emergent intracranial hematoma evacuation and decompressive craniectomy at Tianjin Huanhu Hospital. Postoperatively, he developed intracranial infection with cerebrospinal fluid culture yielding Gram-negative bacteria. Through Matrix-assisted laser desorption ionisation-time of flight mass spectrometry and 16S rDNA gene sequencing, the pathogen was identified as P. ananatis. The bacterium exhibited high susceptibility to multiple antibiotics. Following treatment with Isepamicin, the patient recovered and was discharged from the hospital. To our knowledge, this is the first reported case worldwide of central nervous system infection caused by P. ananatis.