Foreign Body-Associated Eikenella corrodens Aspiration Pneumonia in an Elderly Immunocompetent Adult: A Case Report.

BACKGROUND

Eikenella corrodens, a member of the HACEK group, is a fastidious Gram-negative bacillus that is part of the normal oropharyngeal microbiota and rarely causes lower respiratory tract infections. Pulmonary infections caused by E. corrodens are typically associated with predisposing factors such as aspiration, mucosal injury, or airway obstruction.

CASE PRESENTATION: We report the case of a 79-year-old woman without known immunosuppressive conditions who presented with a several-week history of productive cough and progressive respiratory symptoms. The initial clinical evaluation and chest radiography findings were nonspecific. Subsequent chest computed tomography (CT) revealed left lower lobe consolidation and bilateral apical bronchiolitis. Flexible bronchoscopy revealed a whitish-yellow, plant-derived endobronchial foreign body causing near-complete obstruction of the basal segmental bronchus with purulent secretions distally. Following bronchoscopic removal, a bronchial aspirate collected immediately after extraction yielded E. corrodens in pure culture (>105 CFU/mL), supporting true lower respiratory infection rather than contamination. Histopathological examination confirmed the presence of organic foreign material. The isolate was susceptible to all tested beta-lactams, fluoroquinolones, tetracycline, and co-trimoxazole, and resistant to azithromycin. Susceptibility-guided therapy based on susceptibility testing resulted in clinical and radiological improvement.

CONCLUSION

This case highlights the diagnostic value of bronchoscopy in persistent focal pneumonia and underscores that isolation of E. corrodens in pure culture from appropriately collected lower respiratory specimens should prompt careful evaluation for aspiration or airway obstruction.