An Aeromonas veronii biovar sobria infection with disseminated intravascular gas production.
We report a case of Aeromonas veronii biovar sobria infection with disseminated intravascular gas production. The patient was an afebrile 15-year-old girl who had been quite healthy until the onset of the illness. She came to the hospital because of a 6-h history of increasing pain and swelling in her left thigh. On admission, no infection was suspected, and a tentative diagnosis of a ruptured left gracilis muscle was made. Because the pain increased continuously, the treatment concentrated on pain control. Unexpectedly, abrupt death occurred 23 h after her admission. Postmortem computed tomographic (CT) scans showed an abundance of gas in the blood vessels of the entire body. Postmortem investigation revealed disseminated intravascular gas production, marked intravascular hemolysis, and numerous intravascular Gram-negative bacilli in all organs examined. The organisms were identified as A. veronii biovar sobria, and were highly susceptible to third-generation cephalosporins. Regarding therapeutic problems, the early administration of these antibiotics should reduce the fatality rate in such infections. It is critical to keep the possibility of such an infection in mind when a patient complains of severe muscle pain.
Department of Orthopaedic Surgery, Okinawa Kyodo Hospital, Tomigusuku, Japan. shiinaseikei417@orion.ocn.ne.jp
Yukio
Y
Shiina
Kunio
K
Ii
Masaaki
M
Iwanaga
D000293:Adolescent; D000333:Aeromonas / Q000302:isolation & purification* / Q000378:metabolism; D016757:Death, Sudden, Cardiac; D003937:Diagnosis, Differential; D017809:Fatal Outcome; D005260:Female; D005738:Gas Gangrene / Q000150:complications / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000382:microbiology / Q000473:pathology; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000175:diagnosis* / Q000382:microbiology / Q000473:pathology; D006801:Humans; D007866:Leg; D010146:Pain / Q000209:etiology; D011859:Radiography