Burkholderia cepacia Sepsis in a Case of Acute Pancreatitis: Report from a Tertiary Care Center in North India

Abstract

Background: Burkholderia cepacia complex (Bcc) includes a group of Gram-negative, non-fermenting bacilli that are increasingly recognized as opportunistic and nosocomial pathogens, particularly in patients with underlying conditions. While commonly associated with cystic fibrosis, Bcc infections in immunocompetent individuals are rare but can be severe.Case Presentation: We report a rare case of Burkholderia cepacia sepsis in a 51-year-old hypertensive male without significant comorbidities, who presented with acute necrotizing pancreatitis. The patient initially received broad-spectrum antibiotics and supportive care. Worsening symptoms led to imaging which revealed peripancreatic fluid collections. Culture of peripancreatic aspirate and blood samples yielded B. cepacia, identified using VITEK 2 and confirmed by biochemical testing. The isolate was sensitive to meropenem, ceftazidime, and cotrimoxazole. The patient showed significant clinical improvement with targeted antimicrobial therapy, including ceftazidime-avibactam, levofloxacin, and oral cotrimoxazole.Conclusion: This case highlights the emerging role of B. cepacia as a pathogen in non-cystic fibrosis settings and underscores the importance of routine identification of non-fermenting Gram-negative bacilli in clinical microbiology. Early detection and appropriate antimicrobial therapy are critical to managing such rare but serious infections in acute pancreatitis patient.