Abstract

Paenibacillus azoreducens is a bacterium found in soil and industrial water, known for its ability to reduce complex synthetic dyes. Paenibacillus species infections are rare, opportunistic, often seen in immunocompromised patients. We present the first case report of P. azoreducens infection in a previously healthy pediatric patient following a lower back penetrating injury with a pencil. She subsequently developed a chronic draining wound site complicated by chronic osteomyelitis, that required multiple incision and drainage procedures and a prolonged antimicrobial therapy course. A pencil piece was retrieved and P. azoreducens was isolated from the sample via Matrix-assisted laser desorption ionization-time of flight (MALDI-TOF), sensitivity testing guided antibiotic treatment. This case contributes to the knowledge gap among infections in immunocompetent pediatric patients as Paenibacillus has not been reported in immunocompetent patients. It is important for clinicians to maintain a high index of suspicion of rare pathogens associated with chronic infections as early identification allows targeted antimicrobial therapy. Awareness will contribute to understanding of management in unusual infections in the pediatric population.