title: Skin and soft-tissue manifestations of Shewanella putrefaciens infection.
abstract: Shewanella putrefaciens, a saprophytic gram-negative rod, is infrequently recovered from clinical specimens. Although a number of clinical syndromes have been attributed to S. putrefaciens, the pathogenic role of this agent remains largely undefined. We report 16 cases of S. putrefaciens infection that occurred at the Veterans General Hospital-Kaohsiung in Taiwan between 1990 and 1995. S. putrefaciens infection was associated with a wide clinical spectrum including bacteremia/septicemia, skin and soft-tissue infection, biliary tract infection, peritonitis, and empyema. Five of our patients had skin and soft-tissue manifestations, including fulminant periorbitofacial cellulitis, dacryocystitis, perineal abscess, finger abscess, and postcholecystectomy wound infection. These clinical features deviated from the chronic ulcers or infected burns of the lower extremities that have been described in previous reports. Seven (44%) of our 16 patients had bacteremia/septicemia, and all seven had underlying hepatobiliary diseases. S. putrefaciens was isolated in mixed cultures of specimens from 14 patients; Escherichia coli was the most common coisolate. Hepatobiliary diseases and malignancy were the major predisposing factors for S. putrefaciens infection of the biliary tract and S. putrefaciens bacteremia/septicemia.
authors.affiliation: Department of Internal Medicine, Veterans General Hospital-Kaohsiung, Taiwan, Republic of China.
authors.forename: Y S
authors.initials: YS
authors.lastname: Chen
authors.forename: Y C
authors.initials: YC
authors.lastname: Liu
authors.forename: M Y
authors.initials: MY
authors.lastname: Yen
authors.forename: J H
authors.initials: JH
authors.lastname: Wang
authors.forename: J H
authors.initials: JH
authors.lastname: Wang
authors.forename: S R
authors.initials: SR
authors.lastname: Wann
authors.forename: D L
authors.initials: DL
authors.lastname: Cheng
mesh_terms: D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016470:Bacteremia / Q000175:diagnosis; D004653:Empyema / Q000175:diagnosis / Q000382:microbiology; D005260:Female; D052776:Female Urogenital Diseases / Q000175:diagnosis / Q000382:microbiology; D016905:Gram-Negative Bacterial Infections / Q000175:diagnosis* / Q000453:epidemiology; D006092:Gram-Negative Facultatively Anaerobic Rods; D006787:Hospitals, Veterans; D006801:Humans; D008107:Liver Diseases / Q000150:complications; D008297:Male; D052801:Male Urogenital Diseases; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D009369:Neoplasms / Q000150:complications; D010538:Peritonitis / Q000175:diagnosis / Q000382:microbiology; D012307:Risk Factors; D017192:Skin Diseases, Bacterial / Q000175:diagnosis*; D018461:Soft Tissue Infections / Q000175:diagnosis* / Q000382:microbiology; D013624:Taiwan / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents