Pseudomonas mendocina Meningitis in a Postoperative Patient: A Case Report and Review of Literature

Pseudomonas mendocina is a Gram negative bacillus, belonging to the Pseudomonadaceae family. It was first isolated in 1970 from soil and water of Mendoza region in Argentina. Although, it rarely causes infection, 21 cases of infections ranging from infective endocarditis, bacteraemia, meningitis, soft tissue infections and urinary tract infections are reported worldwide mostly among patients with underlying co-morbidities. This report is the first case of pyogenic meningitis due to Pseudomonas mendocina reported from a 1600 bedded teaching hospital in Northern India and second case of Pseudomonas mendocina infection from the Indian subcontinent. The presented case was of a 31-year-old female who was diagnosed for pituitary macroadenoma on Magnetic Resonance Imaging (MRI). She underwent endoscopic endonasal trans-sphenoidal excision of the tumour after two months of diagnosing the tumour following which she developed meningitis. On two consecutive aerobic bacterial culture and identification by Matrix-Assisted Laser Desorption/Ionisation-Time of Flight-Mass Spectrometry (MALDI-TOF-MS), growth of Pseudomonas mendocina was observed. After Antibiotic Sensitivity Testing (AST) the patient was started on Piperacillin-tazobactam and Amoxicillin-clavulanic acid which lead to alleviate her symptoms of meningitis and was discharged after 27 days of hospital stay.