Creech Zachary A, Truong Gia Thinh D, Kenny Dorothy X, Butt Dua Noor, Li Changzhao, Cavalieri Stephen, El-Herte Rima
Internal Medicine, Creighton University School of Medicine, Omaha, USA.
Internal Medicine, Creighton University School of Medicine, Phoenix, USA.
Cureus. 2022 May 30;14(5):e25480. doi: 10.7759/cureus.25480. eCollection 2022 May.
Freshwater-related infections can be caused by a broad range of pathogens, potentially leading to skin and soft tissue, pulmonary, gastrointestinal, or even systemic diseases. (),a gram-negative, aerobic organism previously regarded solely as an environmental microbe, has been classified as a pathogen capable of causing human infection in the United States. There has been only one other case reported in the literature of infection, and little is known about the pathogenesis.The presentation and progression of clinical symptoms in our cases indicate freshwater cutaneous injury as the most likely route of infection. We present two cases of infection in elderly males. Both patients had freshwater exposure and skin injury resulting in sepsis, cellulitis at the site of injury, and bacteremia. Additionally, one patient presented with an acute deep venous thrombosis. The diagnosis of was confirmed using Sanger sequencing 16s ribosomal RNA data. Antimicrobial therapy included piperacillin-tazobactam, ceftazidime, and levofloxacin. Both patients recovered successfully. While clinical cases and literature involving the newly classified human pathogen are still rare, it is crucial to recognize the potential emergence of environmental organisms, previously believed to be harmless, as human pathogens. In cases of bacteremia and cellulitis with recent freshwater exposure and injury, infection should be considered as part of the differential diagnosis.
与淡水相关的感染可由多种病原体引起,可能导致皮肤和软组织、肺部、胃肠道甚至全身性疾病。嗜麦芽窄食单胞菌是一种革兰氏阴性需氧菌,以前仅被视为一种环境微生物,在美国已被列为能够引起人类感染的病原体。文献中仅报道过一例该菌感染病例,对其发病机制知之甚少。我们病例中的临床症状表现和进展表明,淡水皮肤损伤是最可能的嗜麦芽窄食单胞菌感染途径。我们报告两例老年男性嗜麦芽窄食单胞菌感染病例。两名患者均有淡水接触史和皮肤损伤,导致败血症、损伤部位蜂窝织炎和菌血症。此外,一名患者出现急性深静脉血栓形成。通过桑格测序16s核糖体RNA数据确诊为嗜麦芽窄食单胞菌感染。抗菌治疗包括哌拉西林-他唑巴坦、头孢他啶和左氧氟沙星。两名患者均成功康复。虽然涉及这种新分类的人类病原体嗜麦芽窄食单胞菌的临床病例和文献仍然很少,但认识到以前被认为无害的环境生物体可能成为人类病原体至关重要。在近期有淡水接触和损伤且出现菌血症和蜂窝织炎的病例中,嗜麦芽窄食单胞菌感染应作为鉴别诊断的一部分予以考虑。