title: Aeromonas sobria sepsis complicated by rhabdomyolysis in an HIV-positive patient: case report and evaluation of traits associated with bacterial virulence.
abstract: 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.
authors.affiliation: Clinic of Infectious Diseases, University of Bari, Bari, Italy.
authors.forename: Francesca
authors.initials: F
authors.lastname: Stano
authors.forename: Gaetano
authors.initials: G
authors.lastname: Brindicci
authors.forename: Rosa
authors.initials: R
authors.lastname: Monno
authors.forename: Caterina
authors.initials: C
authors.lastname: Rizzo
authors.forename: Francesca
authors.initials: F
authors.lastname: Ghezzani
authors.forename: Sergio
authors.initials: S
authors.lastname: Carbonara
authors.forename: Emilio
authors.initials: E
authors.lastname: Guaglianone
authors.forename: Gianfranco
authors.initials: G
authors.lastname: Donelli
authors.forename: Laura
authors.initials: L
authors.lastname: Monno
mesh_terms: 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
chemical_list: D000305:Adrenal Cortex Hormones; D001427:Bacterial Toxins; D007166:Immunosuppressive Agents