Background: Ralstonia mannitolilytica  can cause opportunistic infections. Reports on this pathogen identified in the bloodstream are rare worldwide, especially in China.
Case Description: We describe a 48-year-old man who developed sepsis due to bloodstream Ralstonia mannitolilytica  infection after surgery for a perianal abscess. His condition deteriorated into multiple organ dysfunction syndromes until susceptible antibiotics (ceftriaxone and levofloxacin) were administrated based on the drug sensitivity test results. The patient had a satisfactory recovery with no complications during a 6-month follow-up period.
Conclusion: Ralstonia mannitolilytica  blood-borne infection in patients evolves rapidly. The inconsistent sensitivity to antibiotics makes timely treatment difficult and can lead to serious complications. We report the clinical presentations and treatment outcomes for this patient here to remind clinicians about this rare opportunistic pathogen and to highlight the importance of bacterial culture, especially for immunocompromised patients.
Keywords: Ralstonia mannitolilytica , sepsis, shock, perianal abscess, multiple organ dysfunction syndrome