Fatal Aeromonas hydrophila bacteremia in a hemodialysis patient treated with deferoxamine.
A 49-year-old woman undergoing long-term hemodialysis and treated with deferoxamine (DFO) 1.5 g twice weekly for aluminum bone disease developed fever and bilateral calf pain caused by myonecrosis with gas gangrene. She had a rapidly fatal outcome. The cultures of blood and aspirates from both calf muscles demonstrated Aeromonas hydrophila. No obvious entry point could be traced. The in vitro growth of the patient's strain was found to be stimulated by the deferoxamine-iron complex in an iron-deprived medium. It is suggested that high-dose DFO therapy in this patient was responsible for promoting a bacterial infection by this microorganism.
Lin
S H
SH
Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, Republic of China.
Shieh
S D
SD
Lin
Y F
YF
De Brauwer
E
E
Van Landuyt
H W
HW
Gordts
B
B
Boelaert
J R
JR
D016980:Aeromonas hydrophila; D000535:Aluminum / Q000009:adverse effects; D000931:Antidotes / Q000009:adverse effects*; D016470:Bacteremia / Q000382:microbiology*; D001847:Bone Diseases / Q000139:chemically induced / Q000188:drug therapy; D003676:Deferoxamine / Q000009:adverse effects*; D017809:Fatal Outcome; D005260:Female; D005738:Gas Gangrene / Q000382:microbiology; D016905:Gram-Negative Bacterial Infections; D006801:Humans; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000382:microbiology / Q000473:pathology; D009336:Necrosis; D006435:Renal Dialysis / Q000009:adverse effects; D017262:Siderophores / Q000009:adverse effects*
D000931:Antidotes; D017262:Siderophores; D000535:Aluminum; D003676:Deferoxamine