Abstract
Introduction: Alcaligenes faecalis is a rare cause of urinary tract infection (UTI) in humans, especially in pediatrics. It is a potentially emerging pathogen, usually opportunistic, and it is often difficult to treat due to its increased resistance to several antibiotics. Urinary tract infection due to Alcaligenes faecalis in pediatrics it is not yet describe in literature.
Case report: We report the occurrence of Alcaligenes faecalis (spp faecalis) Urinary Tract Infection (UTI), presenting as acute cystitis, in a 14-years-old boy with previous history of non-obstructive bilateral renal lithiasis due to hyperuricosuria, pyelocaliceal duplicity in the right kidney and recurrent UTI. He was treated with empirical antibiotic with amoxicillin/clavulanate, with clinical improvement. A repeated urine culture was sterile after treatment.
Discussion: We review literature in pediatrics, and we found out that this agent is a very uncommon organism of infection and difficult to treat due to its increased resistance to several antibiotics such as penicillin, cephalosporins, carbapenems, aminoglycosides, and quinolones. In pediatric literature, there is still few cases of infection described, due to Alcaligenes faecalis.
Conclusions: Clinicians should continue to direct initial empiric antimicrobial therapy toward the more commonly encountered bacteria. If Alcaligenes faecalis is identified in culture, it can represent a true pathogen, and not merely a contaminant. Alcaligenes faecalis is an unexpected agent of UTI that clinicians should keep in mind.

Key words: Urinary tract infections, Alcaligenes faecalis, hematuria