Abstract
Aeromonas species are recognized as opportunistic pathogens that cause serious problems in patients with liver cirrhosis (LC). In this article, 25 case reports of Aeromonas infections in patients with LC in Japan are reviewed and summarized. Among the 25 cases, cases of septicemia or skin and soft tissue infections have been relatively well reported. In total, the 1-month mortality rate was 68% (17/25), whereas the overall survival rate was 32% (8/25). In particular, among 16 cases with skin and soft tissue infections, 12 (75%) died within the first 4 days after admission, regardless of the administration of antimicrobial agents and/or lower limb amputation, indicating extremely poor short-term prognosis.
Highlights
Patients with Liver Cirrhosis (LC) are at a high risk of developing bacterial infections for several reasons, including hypoactivity of phagocytic cells in the hepatic reticuloendothelial system, decreased production of complement, bacterial translocation partially because of impaired intestinal permeability, and bacterial influx into the general circulation through portacaval shunts [1,2]
The most common bacterial infections identified in patients with LC are Spontaneous Bacterial Peritonitis (SBP), which is a life-threatening infection in patients with ascites; urinary tract infections; respiratory infections, pneumonia, skin and soft tissue infections; and bacteremia [1]
Aeromonas infection is most commonly associated with gastroenterocolitis; extra-intestinal infections, such as bacteremia, pneumonia, empyema, arthritis, endocarditis, meningitis, urinary tract infection, biliary tract infection, peritonitis, including SBP; and skin and soft tissue infections [3]
Summary
Patients with Liver Cirrhosis (LC) are at a high risk of developing bacterial infections for several reasons, including hypoactivity of phagocytic cells in the hepatic reticuloendothelial system, decreased production of complement, bacterial translocation partially because of impaired intestinal permeability, and bacterial influx into the general circulation through portacaval shunts [1,2]. Aeromonas species are recognized as opportunistic pathogens that cause serious problems, especially septicemia in immunocompromised patients with LC, hematological malignancies, diabetes mellitus (DM), severe biliary tract diseases, and renal failure [4,5,6,7]. They cause life-threatening skin and soft tissue infections [3] in addition to Vibrio species, in patients with LC. Chuang et al [2] reported that the severity and mortality of bacteremia caused by A. caviae were lower than bacteremia caused by A. hydrophila or A. sobria.
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