Nelson John J, Nelson Carolyn A, Carter J Elliot
Department of Pathology, University of South Alabama, Mobile, AL, USA.
J La State Med Soc. 2009 Mar-Apr;161(2):103-6.
Edwardsiella tarda, a member of the family Enterobacteriaceae found in aquatic environments, is an unusual cause of human disease, presenting most frequently as gastroenteritis. Extraintestinal manifestations of E. tarda infection are rare but have included meningitis, cholecystitis, endocarditis, osteomyelitis, soft tissue infections, bacteremia, and septicemia. Over a 10-year period at our institution, 10 cases of extraintestinal infection related to E. tarda were identified. The infections ranged from soft tissue infections secondary to trauma to intra-abdominal infections with abscess formation. Several of the patients had documented factors predisposing them to infection including diabetes mellitus and C1 esterase deficiency. Interestingly, two of the patients had chronic idiopathic inflammatory bowel disease, and one patient developed a respiratory tract infection related to E. tarda, a previously unreported clinical manifestion. Although the mortality rate for extraintestinal E. tarda infections has been as high as 50% in some studies, antimicrobial treatment was eventually successful in each of the 10 cases at our institution.
迟缓爱德华氏菌是肠杆菌科的一员,存在于水生环境中,是一种不常见的人类疾病病因,最常表现为肠胃炎。迟缓爱德华氏菌感染的肠外表现罕见,但包括脑膜炎、胆囊炎、心内膜炎、骨髓炎、软组织感染、菌血症和败血症。在我们机构的10年期间,共确诊了10例与迟缓爱德华氏菌相关的肠外感染病例。感染范围从创伤继发的软组织感染到伴有脓肿形成的腹腔内感染。部分患者有记录在案的易感染因素,包括糖尿病和C1酯酶缺乏。有趣的是,其中两名患者患有慢性特发性炎症性肠病,一名患者发生了与迟缓爱德华氏菌相关的呼吸道感染,这是一种此前未报告的临床表现。尽管在一些研究中,迟缓爱德华氏菌肠外感染的死亡率高达50%,但在我们机构的这10例病例中,抗菌治疗最终均取得了成功。