Sphingobacterium multivorum causing fatal meningoencephalitis: a rare case report

Rajesh Kumar Verma, Ramakant Rawat, Amit Singh, Dharmendra Prasad Singh, Vijay Verma


We report a case of fatal meningitis caused by bacteria, Sphingobacterium multivorum, probably first time being reported from India. S. mulivorum has been isolated from various clinical specimens but it is only rarely been associated with serious infections. Sphingobacterium species are generally resistant to aminoglycosides and polymyxin B. Susceptibility to β-lactam antibiotics is variable, requiring testing for individual drug. This 36 year male had two weeks history of high-grade fever with altered sensorium and occasional seizures. Patient admitted with septicemia and subsequently developed meningitis and succumbed to his illness after being discharged against medical advice. His CSF culture yielded S. multivorum subsequently confirmed by mini API, bioMérieux Inc. Marcy-l’Etoile France. Due to its rare association with common clinical conditions, it requires a high degree of suspicion and expertise to prove its presence in clinical specimens. Since this bacterium is inherently resistant to many classes of antibiotics, a vigilant and efficient microbiological work up is needed to establish its diagnosis and prompt treatment.


Sphingobacterium multivorum, Meningitis, Septicemia, Mini API

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Paul C. Schreckenberger, Maryam I. Daneshvar, Dannie G. Hollis. Acinetobacter, Achromobacter, Chryseobacterium, Moraxella and Other Nonfermentative gram negative rods. In: Patric R. Murray, Ellen Jo Barren, James H. Jorgensen, Marie Louise Landry, Michael A. Pfaller, eds. Manual of Clinical Microbiology. 9th ed. Washington, DC: ASM Press; 2007: 539-560.

Fereny, Hansen W, Ploton C, Meugnier H, Madier S, Bornstein N, et al. Septicemia caused by Sphingobacterium multivorum. J Clin. Microbiol. 1987;25:1126-8.

Holmes B, Owen RJ, Weaver RE. Flavobacterium multivorum: a new species isolated from human clinical specimens and previously known as group IIK, biotype 2. Int J Syst Bacteriol. 1981;31:21-34.

Pot B, Gillis M. Genus III. Aquaspirillum Hyelomon, Wells, Krieg and Jannasch 1973b, 361AL. In: Brenner DJ, Krieg NR, Staley JT, Garrity GM, eds. Bergey’s Manual of Systematic Bacteriology. 2nd ed. New York, NY: Springer; 2005: 801-823.

Spangler SK, Visalli MA, Jacobs MR, Appelbaum PC. Susceptibilities of non-Pseudomonas aeruginosa gram negative non-fermentative rods to ciprofloxacin, ofloxacin, levofloxacin, D-ofloxacin, sparfloxacin, ceftazidime, piperacillin, piperacillin-tazobactam, trimethoprim-sulfamethoxazole, and imipenem. Antimicrob Agents Chemother. 1996;40:772-5.

Reina J, Borrell N, Figuerola J. Sphingobacterium multivorum isolated from a patient with cystic fibrosis. Eur J Clin Microbiol Infect Dis 1992;11:81-2.

Grimaldi D, Bonacorsi S, Roussel H, Zuber B, Poupet H, Jean-Daniel Chiche, et al. Unusual “flesh-eating” strain of Escherichia coli. J Clin Microbiol. 2010;48:3794-6.

Marinella MA. Cellulitis and sepsis due to Sphingobacterium. JAMA. 2002;288:1985.

Manfredi R, Nanetti A, Ferri M, Mastroianni A, Coronado OV, Chiodo F. Flavobacterium spp. organisms as opportunistic bacterial pathogens during advanced HIV disease. J Infect. 1999;39:146-52.

Potvliege C, Dejaegher-Bauduin C, Hansen W, Dratwa M, Collart F, Tielemans C, et al. Flavobacterium multivorum septicemia in a hemodialyzed patient. J Clin Microbiol. 1984;19:568-69.

Winthrop KL. Serious infections with antirheumatic therapy: are biologicals worse? Ann Rheum Dis. 2006;65(Suppl 3):iii54-7.

Anaya DA, Dellinger EP. Necrotizing soft-tissue infection: diagnosis and management. Clin Infect Dis. 2007;44:705-10.

Lambiase A, Rossano F, Pezzo MD, Raia V, Sepe A, Gregorio FD, et al. Sphingobacterium respiratory tract infection in patients with cystic fibrosis. BMC Res Notes. 2009;2:262.

Tronel H, Plesiat P, Ageron E, Grimont PA. Bacteremia caused by a novel species of Sphingobacterium. Clin Microbiol Infect. 2003;9:1242-4.