Abstract Delftia acidovorans is a rare, opportunistic Gram-negative bacillus primarily found in environmental sources. Although its clinical significance remains uncertain, it has been isolated from various clinical specimens, often in immunocompromised individuals. Here, we report a case of D. acidovorans isolated from bile in a 62-year-old male with metastatic hepatocellular carcinoma (HCC) and biliary obstruction. The patient presented with jaundice and abdominal distension, and imaging studies revealed features consistent with multifocal HCC, portal vein thrombosis, and bile duct invasion. Endoscopic retrograde cholangiopancreatography confirmed biliary obstruction. Bile samples collected during the procedure were cultured, and the isolates were identified as D. acidovorans with 99% probability using the VITEK 2 Compact System and matrix-assisted laser desorption/ionization time-of-flight. The organism demonstrated susceptibility to beta-lactams and fluoroquinolones but was resistant to aminoglycosides. Despite supportive care, the patient’s condition deteriorated, and he was discharged against medical advice due to financial constraints. The isolation of D. acidovorans from bile raises important questions regarding its pathogenicity, as bile cultures are prone to colonization and contamination. This case underscores the importance of accurate microbial identification, cautious interpretation of bile culture results, and stringent infection control measures in immunocompromised patients undergoing invasive procedures. Given the limited data on D. acidovorans infections, further studies are necessary to clarify its role in human disease and establish evidence-based management guidelines.
Ashraf et al. (Wed,) studied this question.