Abstract Introduction Pantoea agglomerans is a Gram-negative, facultative anaerobic bacillus of the Enterobacteriaceae family, commonly found in plants, soil, and water. Although primarily an environmental organism, it has emerged as an opportunistic pathogen in humans for infections such as bacteremia, septic arthritis, and osteomyelitis. Isolation of P. agglomerans from respiratory specimens is extremely rare and is often dismissed as contamination. Case Presentation In this case, a 64-year-old male with asthma, dysphagia, Lyme's, and paroxysmal atrial fibrillation presented with generalized weakness, malaise, and chronic productive cough accompanied by chills. In the emergency department, he was found to be hypotensive, and chest imaging revealed findings consistent with pneumonia. He was admitted for sepsis secondary to community-acquired pneumonia. Sputum cultures yielded Pantoea agglomerans, with further inquiry revealing the use of a commercially available beeswax-based inhaler for symptomatic cough relief. He was eventually discharged with antibiotics, and after bronchoscopy specimens were negative for any pathogen. This case highlights a rare instance of P. agglomerans respiratory infection potentially linked to inhalation of a natural beeswax-based product. Beeswax, being an unsterilized organic material, may harbor environmental microorganisms. Although definitive causality cannot be proven, this case raises important concerns about the safety of unregulated "natural" inhalation products. Discussion This case also highlights the duty of clinicians to remain vigilant when encountering uncommon pathogens and obtain a detailed exposure history, including use of alternative or herbal therapies. This abstract is funded by: None
Lone et al. (Fri,) studied this question.