Aeromonas sobria infection with severe soft tissue damage and segmental necrotizing gastroenteritis in a patient with alcoholic liver cirrhosis.
A 49-year-old man, who had a 3-year history of liver dysfunction but had not been treated, was admitted to the hospital with a sudden onset of fever and generalized muscle pain. He subsequently developed generalized purpura with scattered hemorrhagic bullae of the skin and massive bloody stools. Aeromonas sobria was proven by culture of both blood and bullous fluid. In spite of the extensive treatment with antibiotics and other medications in the intensive care unit (ICU), the patient went into septic shock and died 2 days after admission. Pathological examination on autopsy revealed segmental necrotizing gastroenteritis with bacterial colonies and alcoholic liver cirrhosis, in addition to extensive severe soft tissue damage involving cellulitis and rhabdomyolysis and epidermolysis. Although the prognosis for Vibrio vulnificus infection with severe soft tissue damage in patients with liver cirrhosis, malignancy, diabetes mellitus or other pre-existing diseases is poor, the unfavorable progression of Aeromonas species, especially A. sobria infection is rare. This is thought to be the first report of an autopsied case.
Itoh
H
H
Second Department of Pathology, Miyazaki Medical College, Japan.
Kuwata
G
G
Tateyama
S
S
Yamashita
K
K
Inoue
T
T
Kataoka
H
H
Ido
A
A
Ogata
K
K
Takasaki
M
M
Inoue
S
S
Tsubouchi
H
H
Koono
M
M
D000333:Aeromonas / Q000302:isolation & purification*; D004298:Dopamine / Q000627:therapeutic use; D020345:Enterocolitis, Necrotizing / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D017809:Fatal Outcome; D005759:Gastroenteritis / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D016905:Gram-Negative Bacterial Infections / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D006801:Humans; D015378:Imipenem / Q000627:therapeutic use; D008104:Liver Cirrhosis, Alcoholic / Q000382:microbiology / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D008911:Minocycline / Q000627:therapeutic use; D009102:Multiple Organ Failure; D009638:Norepinephrine / Q000627:therapeutic use; D012772:Shock, Septic / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology; D018461:Soft Tissue Infections / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*
D015378:Imipenem; D008911:Minocycline; D004298:Dopamine; D009638:Norepinephrine