An unusual infection in a patient with peripherally inserted central catheter

Yanyan Zhou ,Guyi Wang ,Youdi Lv ,Haiyun Dong ,Jinxiu Li ,Jianjun Tang

doi:10.22514/sv102.122015.17

Abstract

A peripherally inserted central catheter (PICC) is widely used in transfusion therapy and for monitoring many kinds of diseases, especially in critically ill patients. Compared with other catheters, it has a lower risk of catheter-related bloodstream infections. Aeromonas Hydrophila (AH) is a kind of opportunistic pathogen, vibrionaceae aeromonas, and gram-negative brevibacterium, widely distributed in nature, in all kinds of body fluid. It usually causes gastrointestinal infections, and rarely causes Aeromonas septicemia. To date, there has been no report of a PICC-related AH infection. We report the case of a 40-year-old female with breast cancer, who suffered post-op. severe sepsis and double lower limb cellulitis with multiple organ failure. All of this was due to AH invading the blood through the PICC.

Highlights

Aeromonas Hydrophila (AH) is a Gram-negative, aquatic bacterium which causes infection in both human beings and animals. [1] Less than 5 cases of catheter-related infections due to AH have been reported in the medical literature, and most of the reports involved infections that were not very serious
We present a case of severe sepsis and cellulitis of both lower limbs due to AH in a breast cancer patient receiving postoperative chemotherapy
(3) Venous access devices ( VADs) related infections caused by AH have only been reported in a dialysis catheter. [4]

Summary

Introduction

Aeromonas Hydrophila (AH) is a Gram-negative, aquatic bacterium which causes infection in both human beings and animals. [1] Less than 5 cases of catheter-related infections due to AH have been reported in the medical literature, and most of the reports involved infections that were not very serious. We present a case of severe sepsis and cellulitis of both lower limbs due to AH in a breast cancer patient receiving postoperative chemotherapy. Despite aggressive treatment, this terrible infection caused multiple organ failure. A 40-year-old female farmer was admitted to our hospital with a fever and left lower limb pain after flushing the PICC by herself 2 days ago She had received 5 cycles of postoperative chemotherapy (docetaxel 120mg, pirarubicin 60mg, cyclophosphamide 800mg for 1 day) for left breast invasive carcinoma, over the past 4 months. The PICC was inserted via ultrasound-guided venepuncture of the right brachial vein Her vital signs were normal except for a high body temperature (38.6°C).

Objectives

Conclusion