Abstract
IntroductionEdwardsiella tarda uncommonly infects humans. The usual presentation is mild gastroenteritis, but systemic manifestations may occur. Lethal infections are rarely documented in patients with underlying disorders.Case presentationA previously healthy 37-year-old Southeast Asian woman presented to our hospital with recent onset of abdominal pain, fever, and vomiting. Her condition rapidly deteriorated with signs and symptoms of fulminant septic shock; thus, she was intubated, supported with intravenous vasopressors and fluids, and transferred to the intensive care unit. An abdominal computed tomographic scan with contrast revealed multiple liver abscesses. Blood cultures were obtained and computed tomography–guided percutaneous drainage of the liver abscesses with supplementary cultures was performed; thereafter, empirical broad-spectrum antibiotics were initiated. All cultures grew E. tarda, whereas an antibiogram showed resistance to broad-spectrum antibiotics and sensitivity to ciprofloxacin and aminoglycosides; thus, the antibiotic regimen was updated accordingly. The patient made an uneventful recovery and was discharged from the intensive care unit 14 days after admission.ConclusionE. tarda human infection can present as liver abscess and fulminant septic shock. E. tarda strains can be resistant to broad-spectrum antibiotics; hence, culture-based antibiotics should be used accordingly. Clinicians should be aware of this rare and potentially lethal infection.
Highlights
Edwardsiella tarda is a gram-negative, facultative anaerobe that is a member of the family Enterobacteriaceae and was first described by Ewing et al in 1965 [1]
We report a case of E. tarda infection that presented as multiple liver abscesses leading to fulminant septic shock in a previously healthy 37-year-old woman
computed tomographic (CT)-guided percutaneous drainage of the liver abscesses with supplementary cultures was performed while blood cultures were derived
Summary
E. tarda human infections could present as liver abscesses and fulminant septic shock even in immunocompetent patients. Authors’ contributions GHB collected the data and drafted the manuscript. AA, SC, WTA, AFM, FGDR, and DK participated in all medical interventions, provided expert consultations regarding the care of the patient, and drafted the final version of the manuscript. All authors read and approved the final manuscript. Ethics approval and consent to participate Written informed consent was obtained from the patient’s next-of-kin for the publication of this case report and any accompanying images. Author details 1Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia. Author details 1Critical Care Department, King Saud Medical City, Riyadh, Saudi Arabia. 2Department of Medical Sciences, Infectious Diseases, University of Turin, Turin, Italy. 3Anesthesia Department, Faculty of Medicine, Tanta University, Tanta, Egypt. 4Department of Critical Care, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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