title: Pantoea species sepsis associated with sickle cell crisis in a pregnant woman with a history of pica.
abstract: BACKGROUND
  Bacteria in the Pantoea genus are plant and soil associated Gram-negative rods described as nosocomial pathogens and as rare causes of community-acquired infections. The latter have been classically associated with gardening and plant thorn injuries and immunocompromised states are additional risk factors. We report a patient with pica and geophagia, Pantoea sepsis, and sickle cell crisis, associations not previously described.
  
  
  METHODS
  A 23-year-old pregnant female presented to the emergency department with sickle cell pain crisis. On the third day of hospitalization the patient developed fever subsequently determined to be caused by Pantoea bacteremia and sepsis. She was successfully treated with a two-week course of ceftriaxone. The patient admitted to a habit of frequently eating large amounts of soil and this geophagia had increased since she became pregnant. She had marked clinical improvement with treatment and she was counseled to stop eating soil.
  
  
  CONCLUSIONS
  This is the first reported case of Pantoea infection possibly associated with geophagia and the first reported case of Pantoea bacteremia and sepsis related to an episode of sickle cell crisis.
authors.affiliation: Family Medicine Residency Program-Florida Hospital, Winter Park, FL, U.S.A.
authors.forename: Morhaf Al
authors.initials: MA
authors.lastname: Achkar
authors.forename: Jordan S
authors.initials: JS
authors.lastname: Rogers
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Muszynski
keywords: Pantoea; anemia; pica; pregnancy; sickle cell