Stano Francesca, Brindicci Gaetano, Monno Rosa, Rizzo Caterina, Ghezzani Francesca, Carbonara Sergio, Guaglianone Emilio, Donelli Gianfranco, Monno Laura
Clinic of Infectious Diseases, University of Bari, Bari, Italy.
Int J Infect Dis. 2009 May;13(3):e113-8. doi: 10.1016/j.ijid.2008.08.003. Epub 2008 Nov 1.
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.
人类感染气单胞菌属并不常见，多数情况是因接触受污染的水或土壤而受伤所致。一名43岁感染了人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）的男性，在接受了为期两周的皮质类固醇治疗自身免疫性贫血后，出现腹泻、皮肤表现及多器官功能障碍综合征，最终死亡。尽管粪便样本多次检测为阴性，但在一次发热高峰期间采集的两组血培养物在尸检时分离出一株革兰氏阴性、氧化酶阳性、β溶血杆菌，鉴定为温和气单胞菌。经验性抗生素治疗未成功。对临床分离株的毒力相关特性（黏附、细胞毒性活性、生物膜形成）评估显示，该菌株是公认毒力因子的低产者，这表明HIV感染、HCV相关肝硬化和皮质类固醇的不幸共存在临床病程中起了关键作用。
