Nikiforov Ivan, Goldman John, Cheriyath Pramil, Vyas Anix, Nookala Vinod
Department of Medicine, PinnacleHealth System, Harrisburg Hospital, BMAB 3-C, 207 South Front Street, Harrisburg, PA 17104, USA.
Case Rep Infect Dis. 2014;2014:163040. doi: 10.1155/2014/163040. Epub 2014 Nov 19.
Introduction. Aeromonas hydrophila is a gram negative bacillus that is native to aquatic environments that is increasingly reported in humans. This case is remarkable for A. hydrophila with an initial presentation of acute pancreatitis. Case Presentation. A 61-year-old male presented to the emergency department with nausea, vomiting, and abdominal pain for two days. His past medical history was significant for alcohol abuse. Initial laboratory examination showed an elevated white blood cell count, elevated lipase, and elevated liver function tests (LFT). Computer tomography (CT) showed peripancreatic inflammatory changes and retroperitoneal free fluid, suggestive of acute pancreatitis. The patient was treated with intravenous (IV) fluids and IV meropenem. After two days, the patient developed sepsis and respiratory failure and was intubated. Blood cultures were positive for Aeromonas hydrophila sensitive to ciprofloxacin which was added to his treatment. Additionally, it was discovered that this patient had recently vacationed in Florida where he consumed raw oysters. He was discharged home on the eighth day of the hospital admission. Conclusion. This is a rare case of A. hydrophila sepsis in an elderly patient with acute pancreatitis and a history of consumption of raw oysters. This case suggests that A. hydrophila can cause disseminated infection in immunocompetent individuals.
引言。嗜水气单胞菌是一种革兰氏阴性杆菌,原产于水生环境,在人类中的报告越来越多。该病例因嗜水气单胞菌引发急性胰腺炎初发表现而引人注目。病例报告。一名61岁男性因恶心、呕吐和腹痛两天就诊于急诊科。他既往有酗酒史。初始实验室检查显示白细胞计数升高、脂肪酶升高和肝功能检查(LFT)升高。计算机断层扫描(CT)显示胰腺周围炎症改变和腹膜后游离液体,提示急性胰腺炎。患者接受了静脉输液和静脉注射美罗培南治疗。两天后,患者出现败血症和呼吸衰竭并插管。血培养显示嗜水气单胞菌对环丙沙星敏感,遂将其加入治疗。此外,发现该患者近期在佛罗里达州度假,期间食用了生牡蛎。患者在入院第八天出院。结论。这是一例老年患者因急性胰腺炎且有食用生牡蛎史而发生嗜水气单胞菌败血症的罕见病例。该病例提示嗜水气单胞菌可在免疫功能正常个体中引起播散性感染。