Pneumonia caused by Actinobacillus ureae in an immunocompetent healthy young male: a case report

Actinobacillus ureae is a commensal found in the respiratory tract of humans. It is known to cause infections such as meningitis and septic arthritis in immunocompromised patients and also pneumonia especially in those with underlying chronic respiratory diseases. We report a case of right lower lobe pneumonia in a 15-year-old immunocompetent male who did not have any chronic illness including respiratory disease. Sputum analysis showed Gram-negative bacilli initially identified as Haemophilus ducreyi based on conventional biochemical tests. Later the organism was confirmed by VITEK® 2 COMPACT to be A. ureae. The patient was treated successfully with intravenous ceftriaxone followed by oral cefixime and doxycycline. Immunodeficiency, chronic illness, or significant environmental exposures except for frequent use of swimming pools and locker rooms were absent. It was hypothesised that he would have acquired the infection at these moist environments. The case underscores the need for heightened clinical awareness of rare pathogens, particularly in atypical presentations, and emphasizes the importance of advanced tests even in resource-limited settings. Hygiene in swimming pools and similar environments must be prioritized to prevent such infections.