title: Shewanella infection in decompensated liver disease: a septic case.
abstract: Shewanella species are an unusual cause of disease in humans. However, reports of Shewanella infections have been increasing, and hepatobiliary disease has been proposed as a predisposing factor following a critical course. We report the first Japanese septic case of decompensated liver disease in which this bacterium acted as a definite pathogen. A 67-year-old Japanese man with primary sclerosing cholangitis was admitted to our hospital complaining of fever, general fatigue, pain, and a rash on the lower left extremity. He was tentatively diagnosed with necrotizing fasciitis caused by Vibrio vulnificus because of his decompensated cirrhotic liver and history of consuming raw fish. Thereafter, the diagnosis was altered to cellulitis and Shewanella septicemia on the basis of the characteristics of his skin lesion and an arterial blood culture. He died of multiple organ failure on the eleventh day in the hospital. Since several reports have demonstrated that Shewanella can cause lethal sepsis in patients with hepatobiliary disease, we should be aware of the pathogenicity of this bacterium.
authors.affiliation: Department of Internal Medicine, Karatsu Red Cross Hospital, 1-5-1 Futago, Karatsu, Saga, 847-8588, Japan.
authors.forename: Taiga
authors.initials: T
authors.lastname: Otsuka
authors.forename: Takahiro
authors.initials: T
authors.lastname: Noda
authors.forename: Akinori
authors.initials: A
authors.lastname: Noguchi
authors.forename: Haruki
authors.initials: H
authors.lastname: Nakamura
authors.forename: Kazuo
authors.initials: K
authors.lastname: Ibaraki
authors.forename: Kotaro
authors.initials: K
authors.lastname: Yamaoka
mesh_terms: D000368:Aged; D002760:Cholangiopancreatography, Endoscopic Retrograde; D015209:Cholangitis, Sclerosing / Q000453:epidemiology*; D017809:Fatal Outcome; D016905:Gram-Negative Bacterial Infections / Q000453:epidemiology*; D006801:Humans; D008103:Liver Cirrhosis / Q000453:epidemiology* / Q000382:microbiology; D008107:Liver Diseases / Q000382:microbiology*; D008297:Male; D018805:Sepsis / Q000382:microbiology*; D020592:Shewanella