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A 71-year-old male develops acute respiratory distress 4 weeks after a bone marrow transplant. The patient experiences fever, tachycardia and worsening mentation. Blood and respiratory cultures reveal a gram-negative bacillus, which was not identified by rapid respiratory and blood culture molecular panels. The microorganism is a non-lactose fermenter, and colonies are smooth and slightly raised on blood agar. There is also a notable dirt-like smell. 

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Author Information

Eric Ransom, Ph.D., D(ABMM), Assistant Professor of Pathology, Case Western Reserve University, Assistant Medical Director of Clinical Microbiology, University Hospitals Cleveland Medical Center.
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