title: Upper extremity myonecrosis caused by Edwardsiella tarda resulting in transhumeral amputation: case report.
abstract: Necrotizing soft tissue infections are rapidly progressive infections with a high rate of mortality. One type of necrotizing soft tissue infection is caused by marine gram-negative bacteria and commonly occurs in immunocompromised hosts. These types of infections are more common in patients with chronic liver disease, possibly because of impaired iron metabolism. We present the case of a rapidly progressive necrotizing soft tissue infection caused by Edwardsiella tarda, a marine gram-negative pathogen common in catfish. Few extraintestinal infections of E tarda have been described previously. Our patient had hepatitis C and was exposed to the bacteria by a puncture injury from a wild catfish. His infection required multiple debridements and ultimately required a transhumeral amputation for local control of the infection.
authors.affiliation: Department of Orthopaedic Surgery, Vanderbilt University Medical Center, Nashville, TN 37232-8774, USA. samuel.n.crosby@vanderbilt.edu
authors.forename: Samuel N
authors.initials: SN
authors.lastname: Crosby
authors.forename: Mark C
authors.initials: MC
authors.lastname: Snoddy
authors.forename: Cameron T
authors.initials: CT
authors.lastname: Atkinson
authors.forename: Donald H
authors.initials: DH
authors.lastname: Lee
authors.forename: Douglas R
authors.initials: DR
authors.lastname: Weikert
mesh_terms: D000671:Amputation, Surgical; D000818:Animals; D000900:Anti-Bacterial Agents / Q000008:administration & dosage; D002397:Catfishes; D002443:Ceftriaxone / Q000008:administration & dosage; D015897:Comorbidity; D003646:Debridement; D018450:Disease Progression; D020609:Edwardsiella tarda; D004756:Enterobacteriaceae Infections / Q000150:complications* / Q000453:epidemiology / Q000601:surgery; D005205:Fascia / Q000473:pathology; D006230:Hand Injuries / Q000150:complications / Q000382:microbiology* / Q000473:pathology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D018482:Muscle, Skeletal / Q000473:pathology*; D009336:Necrosis; D018461:Soft Tissue Infections / Q000453:epidemiology / Q000382:microbiology* / Q000601:surgery; D034941:Upper Extremity / Q000473:pathology; D014950:Wounds, Penetrating / Q000150:complications / Q000382:microbiology* / Q000601:surgery
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone