A case of fasciitis localized in the calf muscles associated with Edwardsiella tarda sepsis

Abstract

A 49-year-old man presented with fever and pain, redness, swelling, and difficulty in walking. The serum C-reactive protein (CRP), creatin kinase (CK), and endotoxin levels were elevated. A blood culture revealed Edwardsiella tarda(E. tarda). Computed tomography (CT) showed subfascial and subcutaneous low-density areas in the lower legs, suggesting focal abscesses and edema. The patient was likely to have necrotizing fasciitis or cellulitis. He was successfully treated with several antibiotics and discharged after 43 days. Because E. tarda causes sepsis and fulminating necrotizing fasciitis with a high mortality rate in patients with an underlying illness, it should be considered a potentially important pathogen. The lack of an underlying illness may be a factor for a good outcome in this case.

Edwardsiella tarda Bacteremia. A Rare but Fatal Water‐ and Foodborne Infection: Review of the Literature and Clinical Cases from a Single Centre

“…Reported environmental risks included direct exposure to fresh or brackish water (lacerated forearm after a fall into brackish water [28] and fishing [28,36]), soil (farming [8] and gardening [12]) and animal feces (working in a zoo [20]). The parents of two neonatal cases were exposed to fresh water; the father from one case was a dock maintenance worker at a lake and his wife participated in a baptism involving immersion in a lake while pregnant, and a mother from another case washed clothes in a river resulting in confirmed maternal colonization ( 29 , 50 ). Reported dietary risks included exposure to raw fish/sushi ( 48 , 50 , 51 ) (TWMU-5 in Table 2 ), raw meat ( 27 ), ceviche during a trip to Ecuador ( 45 ) and unpasteurized goat’s milk ( 46 ).…”

“…The seasonal distribution of ETB is shown in Figure 2 . The majority of the cases that provided a description of the time of onset (18 of 22 [81.8%]) ( 10 , 12 , 13 , 15 , 16 , 18 , 21 , 25 , 28 , 33 , 38 , 40 – 42 , 45 , 50 , 51 ) (TWMU-1, −2, −3, −4, −5 in Table 2 ) occurred during the northern hemisphere summer and autumn months (June to November).…”

Spontaneous bacterial peritonitis caused by Edwardsiella tarda: A case report

“…Gastroenteritis is the most common manifestation that spontaneously resolves without antibiotics [ 1 ]. However, as mentioned earlier, extraintestinal infections can occur in certain susceptible individuals [ [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] ]. Although E. tarda is sensitive to antibiotics with activity against gram-negative bacilli, the prognosis of sepsis caused by this organism is extremely poor [ 2 ].…”

“…We also conducted a literature search and identified a total of 14 cases, including the present case, of E. tarda infection with a surgically treatable source of extraintestinal complications in Japan [ [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] ] ( Table 1 ). It was found that most patients had a significant underlying disease, with the most common ones being hepatobiliary disease (cirrhosis, alcoholic liver injury, common bile duct stone and cholecystectomy; 7/14 [50%]), malignancy (gastric cancer and appendiceal cancer; 3/14 [21%]), and diabetes mellitus (2/14 [14%]).…”

“…Gastroenteritis is the most common manifestation [ 1 ]. However, extraintestinal infections, including soft tissue infection, sepsis, hepatobiliary infection, intra-abdominal abscess, wound infection, meningitis, osteomyelitis, endocarditis, tubo-ovarian abscess, empyema, and salpingitis, can occur in immunocompromised hosts as well as patients with hepatobiliary disease, malignancy, and/or diabetes mellites [ [2] , [3] , [4] , [5] , [6] , [7] , [8] , [9] , [10] , [11] , [12] , [13] , [14] ]. The prognosis of sepsis caused by E. tarda is extremely poor, with a mortality rate of 38% [ 2 ].…”