Fatal sepsis caused by Pigmentibacter ruber: the fourth case reported worldwide with the first environmental metagenomic detection

Pigmentibacter ruber is a rare Gram-negative bacterium increasingly recognized as a potential cause of aspiration pneumonia and sepsis in drowning patients. Only three human infections with this organism have been reported worldwide to date. Here we report the fourth case of P. ruber sepsis globally, and the second in China. Notably, sequences identified as P. ruber were detected in environmental water of the Dongting Lake basin. One of these sequences was recovered from a river in the immediate vicinity of the exposure site established through the patient interview.