Aeromonas sobria sepsis complicated by rhabdomyolysis in an HIV-positive patient: case report and evaluation of traits associated with bacterial virulence.
Human infection with Aeromonas species is uncommon and most often due to trauma with exposure to contaminated water or soil. A 43-year-old HIV- and hepatitis C virus (HCV)-infected male, after a two-week course of corticosteroid therapy for an autoimmune anemia, developed diarrhea, dermatologic manifestations and a multiple organ dysfunction syndrome, resulting in death. Although stool samples were repeatedly negative, two sets of blood cultures obtained during a single peak of fever yielded the post-mortem isolation of a Gram-negative, oxidase-positive, beta-hemolytic bacillus that was identified as Aeromonas sobria. Empiric antibiotic therapy was unsuccessful. Evaluation of the virulence-associated traits of the clinical isolate (adhesion, cytotoxicity activity, biofilm production) showed that the strain was a poor producer of recognized virulence factors, thereby indicating that the unfortunate coexistence of HIV infection, HCV-related liver cirrhosis and corticosteroids played a key role in the clinical course.
Stano
Francesca
F
Clinic of Infectious Diseases, University of Bari, Bari, Italy.
Brindicci
Gaetano
G
Monno
Rosa
R
Rizzo
Caterina
C
Ghezzani
Francesca
F
Carbonara
Sergio
S
Guaglianone
Emilio
E
Donelli
Gianfranco
G
Monno
Laura
L
D000305:Adrenal Cortex Hormones / Q000009:adverse effects; D000328:Adult; D000333:Aeromonas / Q000302:isolation & purification / Q000472:pathogenicity*; D001422:Bacterial Adhesion; D001427:Bacterial Toxins / Q000032:analysis; D002460:Cell Line; D017809:Fatal Outcome; D016905:Gram-Negative Bacterial Infections / Q000150:complications / Q000382:microbiology*; D015658:HIV Infections / Q000150:complications*; D019698:Hepatitis C, Chronic / Q000150:complications*; D006801:Humans; D016867:Immunocompromised Host; D007166:Immunosuppressive Agents / Q000009:adverse effects; D008297:Male; D012206:Rhabdomyolysis / Q000150:complications*; D018805:Sepsis / Q000150:complications / Q000276:immunology / Q000382:microbiology*; D014774:Virulence
D000305:Adrenal Cortex Hormones; D001427:Bacterial Toxins; D007166:Immunosuppressive Agents