First reported case of Alcaligenes faecalis isolated from bronchoalveolar lavage in a patient with dengue hemorrhagic fever

Bacterial co-infections have been reported in association with dengue fever (DF) and can exacerbate dengue infections. However, DF with acute respiratory distress syndrome and co-infection with Alcaligenes faecalis (A. faecalis) has not been reported earlier. Most infections caused by A. faecalis are opportunistic. Urinary tract infection, bacterial keratitis, postoperative endophthalmitis, skin and soft tissue infections, bacteremia, meningitis, wound infections, and peritonitis in patients undergoing peritoneal dialysis have been described in association with A. faecalis. A. faecalis, a Gram-negative environmental organism rarely cause significant infections. Treatment can be difficult in some cases due to the high level of resistance to commonly used antibiotics. We report a case of fatal bronchopneumonia caused by extensively drug resistance A. faecalis in a patient of dengue hemorrhagic fever.