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Hafnia alvei pneumonia: a rare cause of infection in the multimorbid or immunocompromised
  1. Austin Begbey,
  2. Joseph Henry Guppy,
  3. Chithra Mohan and
  4. Simon Webster
  1. Respiratory Medicine, Tunbridge Wells Hospital, Tunbridge Wells, UK
  1. Correspondence to Dr Joseph Henry Guppy; joseph.guppy1{at}


Hafnia alvei is a rare, poorly understood commensal bacterium which has, on occasion, been shown to infect humans. We present two cases. The first patient presented with a 1-week history of dyspnoea, pleurisy and a productive cough, and the second with a prodrome of fatigue and night sweats. The former had a history of severe chronic obstructive pulmonary disease and the latter had a history of Crohn’s disease. Both patients had underlying comorbidities and immunosuppression, but differed in presentation, radiological findings and recovery. This case series aims to remind readers of the broad differential of pathogens that can lead to disease in the immunocompromised and that one should not dismiss atypical cultured bacteria as commensal too hastily.

  • infections
  • respiratory system
  • pneumonia (respiratory medicine)
  • pneumonia (infectious disease)

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  • AB and JHG are joint first authors.

  • Contributors AB: Identified cases and provided oversight of writing and editing. JHG: Wrote the main text, including introduction for patient 1 and discussion. CM: Wrote patient 2 case. SW: Editor, and provided suggestions and comments for the discussion.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Obtained.

  • Provenance and peer review Not commissioned; externally peer-reviewed.