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Rationale: Rhizobium radiobacter is a Gram-negative pathogen present in soil and plants. Cases of R radiobacter infection in immunocompromised hosts have been sporadically reported. However, septic shock caused by R radiobacter is rarely seen.

Patient concerns: Here, we describe an elderly patient with a rapid progression of watery diarrhea, anorexia, fever, weakness, oliguria, and shock. Blood results showed increased total white blood cell count and C-reactive protein. Arterial blood gas results showed hypoxia and elevated lactate level. The Sequential Organ Failure Assessment score was 11. Blood culture at admission showed Gram-negative bacteria, which were later confirmed as R radiobacter.

Diagnosis: Septic shock caused by R Radiobacter.

Interventions: The patient was treated with intravenous cefoperazone/sulbactam and sequential oral levofloxacin.

Outcomes: The patient recovered completely.

Conclusion: R radiobacter may be considered as a potential opportunistic pathogen that may cause severe sepsis in elderly patients, especially those with multiple underlying diseases.

Copyright (C) 2019 The Authors. Published by Wolters Kluwer Health, Inc. All rights reserved.