title: Septic shock due to Aeromonas hydrophila bacteremia in a patient with alcoholic liver cirrhosis: a case report.
abstract: BACKGROUND
  Aeromonas hydrophila sometimes causes bacteremia, which can be fatal in compromised patients, such as those with liver cirrhosis. We present a case of septic shock due to Aeromonas hydrophila bacteremia in a patient with liver cirrhosis, which was successfully treated with rapid resuscitation and critical care.
  
  
  METHODS
  A 71-year-old Japanese man with liver cirrhosis was transported to our emergency center by ambulance after presenting with gait difficulties and fever. On arrival, he exhibited shock and severe lactic acidosis, which was suggestive of sepsis, and was immediately resuscitated and administered empiric antibiotic therapy. He also displayed catecholamine-resistant hypotension, which was successfully treated with critical care including supportive therapies, such as polymyxin B hemoperfusion and cytokine-absorbing hemofiltration. Aeromonas hydrophila was detected in his initial blood cultures.
  
  
  CONCLUSIONS
  Aeromonas septicemia should be considered in patients with alcoholic liver cirrhosis who have profound shock. In addition to goal-directed therapy and the prompt administration of empiric antibiotic therapy, aggressive critical care involving multiple supportive therapies can save such patients.
authors.affiliation: Advanced Emergency and Critical Care Medical Center, Okayama University Hospital, 2-5-1 Kita-ku, Shikata-cho, Okayama-shi, Okayama 700-8558, Japan. tyumoto@cc.okayama-u.ac.jp.
authors.forename: Tetsuya
authors.initials: T
authors.lastname: Yumoto
authors.forename: Shingo
authors.initials: S
authors.lastname: Ichiba
authors.forename: Nao
authors.initials: N
authors.lastname: Umei
authors.forename: Sunao
authors.initials: S
authors.lastname: Morisada
authors.forename: Kohei
authors.initials: K
authors.lastname: Tsukahara
authors.forename: Keiji
authors.initials: K
authors.lastname: Sato
authors.forename: Toyomu
authors.initials: T
authors.lastname: Ugawa
authors.forename: Yoshihito
authors.initials: Y
authors.lastname: Ujike
mesh_terms: D016980:Aeromonas hydrophila / Q000302:isolation & purification*; D000368:Aged; D016470:Bacteremia / Q000150:complications* / Q000382:microbiology; D016905:Gram-Negative Bacterial Infections / Q000150:complications* / Q000382:microbiology; D006801:Humans; D008104:Liver Cirrhosis, Alcoholic / Q000150:complications*; D008297:Male; D012772:Shock, Septic / Q000150:complications* / Q000382:microbiology