Park Se Young, Nam Hyun Min, Park Kun, Park Seok Don
Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea.
Ann Dermatol. 2011 Sep;23 Suppl 1(Suppl 1):S25-9. doi: 10.5021/ad.2011.23.S1.S25. Epub 2011 Sep 30.
Aeromonas hydrophila is a facultatively anaerobic, asporogenous gram-negative rod that has often been regarded as an opportunistic pathogen in hosts with impairment of a local or general defense mechanism. A 68-year-old alcoholic woman presented with shock and gangrene on the right arm. At first, her clinical presentations were severe painful erythematous swelling that worsened within a few hours with development of gangrene, edema, and blisters. Bullous fluid and blood cultures yielded A. hydrophila. Histopathological findings of sections obtained from the vesicle revealed subepidermal vesicles; necrosis of the epidermis, papillary dermis, and subcutaneous fat; and massive hemorrhage in the subcutis. Despite all efforts to save the patient, she died 8 hours after admission. Clinical features of A. hydrophila sepsis resemble those of Vibrio vulnificus sepsis. Therefore, in addition to the case report, we compared the cultural, biochemical, and morphological differences between A. hydrophila and V. vulnificus for facilitation of early and accurate identification of the causative agent.
嗜水气单胞菌是一种兼性厌氧、无芽孢的革兰氏阴性杆菌,常被视为在局部或全身防御机制受损宿主中的机会致病菌。一名68岁的酗酒女性出现休克和右臂坏疽。起初,她的临床表现为严重疼痛性红斑肿胀,数小时内随着坏疽、水肿和水疱的出现而加重。大疱液和血培养分离出嗜水气单胞菌。从水疱处获取的切片组织病理学检查发现表皮下水疱;表皮、乳头真皮和皮下脂肪坏死;皮下大量出血。尽管全力抢救,患者入院8小时后死亡。嗜水气单胞菌败血症的临床特征与创伤弧菌败血症相似。因此,除病例报告外,我们比较了嗜水气单胞菌和创伤弧菌在培养、生化和形态学上的差异,以利于早期准确鉴定病原体。