Aeromonas hydrophila fulminant pneumonia in a fit young man.

Abstract

(Pao2) and carbon dioxide (Paco2) tensions when he was breathing air were 6-7 and 3-6 kPa; the pH was 7-38. Intensive medical support, including assisted ventilation, was begun but his arterial blood gas tensions continued to deteriorate. After two hours of intensive medical aid he coughed up about 15 ml of bright red blood, became severely shocked, and despite intensive medical efforts died three hours after admission.At necropsy the lungs were heavy, the left lung weighing 790 g and the right 870 g. The right lung was uniformly and diffusely solid and the left lung had multiple confluent foci. Microscopically there was vascular engorgement and the alveoli were flooded with erythrocytes and mononuclear and granular leucocytes. Zones of necrosis and haemorrhage were present. Many small Gram negative bacilli were seen in both lungs, especially in the areas of necrosis. Other organs were normal apart from generalised congestion.An organism recovered from blood was cultured on a brain-heart infusion at 37°C after 24 hours and one from a necropsy sample of the lung after plating on to blood agar and McConkey agar and overnight incubation at 37°C. It was provisionally identified as Aeromonas sp on the basis of aerobic growth of a Gram negative rod, being oxidase and catalase positive and showed ,B haemolysis of blood agar. Its final identification as A hydrophila was confirmed by the API 20 NE technique (API System), isolates from the two sources having the same biochemical profiles.Antibiotic sensitivity testing was performed by the comparative disc diffusion method4 on DST agar at 37°C. The organism was resistant to ampicillin, carbenicillin, and cephalothin and sensitive to gentamicin, amikacin, cefuroxime, and co-trimoxazole. Discussion

Aeromonas spp. clinical microbiology and disease

“…Cases of pneumonia in previously healthy individuals caused by Aeromonas infection have been previously reported. 59,60 Such respiratory infections are often caused by near-drowning experiences or inhalation of water whilst swimming. 61e63 However, such cases are extremely rare with Aeromonas linked pneumonia and lung abscesses usually as a result of an underlying medical condition such as cardiovascular disease or alcohol abuse.…”

Prospective Nationwide Study of Aeromonas Infections in France

“…on May 11, 2018 by guest http://jcm.asm.org/ respiratory tract pathogen, although rarely encountered (2,11,13,15,25,26,28,33), our cases with mixed culture were categorized as "possible infection" to better reflect the RTI frequency. Finally, four specific infections included ocular infection, hepatobiliary infection, urinary tract infection, and peritonitis with mesenteric ulcer perforation, all occasionally reported (4,5,13,27).…”

Rapidly Progressive Pneumonia Due to Aeromonas hydrophila Shortly after Near-drowning.

“…It has been regarded as an opportunistic agent that causes sepsis, soft tissue infection, and gastroenteritis in immunologically compromised hosts (7). Recently, pneumonia due to this organism has been reported to develop even in healthy immunocompetent people and 16 cases of pneumonia have been described in the English literature (8-14); seven cases were associated with near-drowning and the details were available in five cases (9)(10)(11)(12). Pneumonia developed in previously healthy young men in four of the five cases, while the other patient had liver cirrhosis.…”