A Case of Invasive Brevibacterium Bacteremia in a Severely Immunocompromised Patient

Brevibacterium spp., previously considered nonpathogenic skin commensals, have emerged as opportunistic pathogens in immunocompromised hosts with central venous catheters or malignancies. We report a case of Brevibacterium bacteremia in a 47-year-old HIV-positive woman with profound immunosuppression (CD4+ T-cell count of 1 cell/µL) but notably without any indwelling catheter or prosthetic device. The patient presented with syncope and pancytopenia and was ultimately diagnosed with Brevibacterium bacteremia after extensive workup. She was successfully treated with a two-week course of intravenous vancomycin, with resolution of bacteremia. This case highlights the need to consider these organisms in severely immunocompromised patients, even in the absence of indwelling catheters. Vancomycin remains an effective treatment.