A Rare Case of Pneumonia Caused byShewanella putrefaciens

Abstract

Shewanella putrefaciens is a gram-negative, nonfermentative, oxidase positive, motile bacillus that produces hydrogen sulphide. It is found widely in the nature especially in marine environments. In some very rare cases Shewanella putrefaciens can be a human pathogen. It can produce a wide variety of clinical syndromes including bacteremia as well as skin and soft tissue infections. However, pneumonia due to S. putrefaciens is rare; there are a total of 4 reported cases in the literature. We present a case of 63-year-old male who was presented to emergency room status after cardiac arrest, fell into sea water face down. On the second day of hospitalization, he was diagnosed to have pneumonia based on the clinical, radiological, and laboratory findings. Empirical antibiotic treatment with vancomycin and piperacillin/tazobactam combination was initiated. Gram-stained smear of endotracheal aspirate yielded gram-negative bacteria, and the isolate grown from endotracheal aspirate culture was identified as S. putrefaciens by Biomerieux API 20 NE technique. On review of the literature and according to culture and sensitivity results, therapy in our patient was changed to cefepime. Patient's pneumonia improved with treatment with cefepime. We believe that our patient developed pneumonia evidently caused by S. putrefaciens, after near drowning in sea water. The pneumonia resolved after treatment with cefepime.

Shewanella putrefaciens: An Emerging Cause of Nosocomial Pneumonia

“…Shewanella putrefaciens is a rarely pathogenic, widely distributed, oxidase positive, nonfermenting, hydrogen sulfide forming gram-negative bacilli. 2 - 4 These species are a part of microflora of marine environment and exposure to marine sources is considered an important risk factor for human diseases. 3 , 4 It can also be found on other sources such as soil, dairy products, oils, poultry, and medical devices.…”

“… 1 Shewanella putrefaciens is an uncommon gram-negative bacilli, which commonly causes otitis media and soft tissue infections often after trauma or exposure to water sources. 2 - 4 Rarely, it can lead to pneumonia and life-threatening bacteremia particularly in immunocompromised patients. 2 - 4 In this article, we report a case of an 84-year-old Caucasian male who was diagnosed with Shewanella pneumonia treated with cefepime with minimal to no improvement in his symptoms.…”

“… 2 - 4 Rarely, it can lead to pneumonia and life-threatening bacteremia particularly in immunocompromised patients. 2 - 4 In this article, we report a case of an 84-year-old Caucasian male who was diagnosed with Shewanella pneumonia treated with cefepime with minimal to no improvement in his symptoms. To the best of our knowledge, this is the third reported case of S putrefaciens nosocomial pneumonia and first case of bacteremia secondary to pneumonia by S putrefaciens .…”

Seawater drowning-associated pneumonia: a 10-year descriptive cohort in intensive care unit

“…Water composition (i.e., freshwater or seawater) and locality may influence such susceptibility patterns [ 2 ]. However, to the best of our knowledge, microbial data in seawater drowning-associated pneumonia are very scarce and generally gathered from cases reports [ 7 – 10 ] or reviews of cases from warm seas [ 3 ] but none from temperate Mediterranean zones.…”

Case Report: Disseminated Shewanella algae Infection with Meningoencephalitis in a Traveler Secondary to Marine Injury in Madagascar

“…Most cases affect patients with disabilities and occur in warm climates after contact with saline water. 1 The most frequent infections are skin and soft tissue infections, 2,3 pneumonia, 4 and hepatobiliary infections. To our knowledge, no case of disseminated Shewanella algae infection with meningoencephalitis has been described in the literature to date.…”