Edwardsiella tarda: A Classic Presentation of a Rare Fatal Infection, with Possible New Background Risk Factors

Abstract

Patient: Female, 59-year-old Final Diagnosis: Sepsis Symptoms: Acute kidney injury • pancytopenia • respiratory deterioration • sepsis Medication: — Clinical Procedure: Mechanical ventilation Specialty: Critical Care Medicine • Infectious Diseases Objective: Rare disease Background: Edwardsiella tarda is a facultative anaerobic bacterium that is rarely pathogenic to humans, but, in patients with certain risk factors, it can lead to severe, disseminated infections. Humans are inoculated through the gastrointestinal tract while consuming undercooked or raw seafood or through skin penetration. E. tarda has been isolated from marine environments, including lakes, rivers, wells, and sewage water. Although the bacterium has not been directly isolated from seawater, it has been cultured from animals inhabiting seawater environments. In the United States, E. tarda is predominantly localized along the coastline of the Gulf of Mexico. Complications from this bacterium usually arise in patients with liver disease, iron overload, or cirrhosis or in those who are immunocompromised or on immunosuppressive therapy. Case Report: Our patient was a 59-year-old woman with a history of advanced lung cancer, pulmonary hypertension, liver cirrhosis, hepatitis C, and alcoholism. She initially presented to the Emergency Department in the Florida Panhandle on June 16 with colitis, which then progressed to fulminant sepsis with septic shock. Despite aggressive interventions, including intravenous hydration, broad-spectrum antibiotics, and vasopressor support, our patient succumbed to her illness approximately 34 h after initial presentation. Conclusions: Although severe cases of E. tarda have been reported in patients with liver dysfunction, we believe this is the first reported case potentially complicated by concomitant lung cancer. The rise in sea water temperature, increased human consumption of raw seafood, and increased prevalence of nonalcoholic steatohepatitis may increase the incidence and mortality of E. tarda in the near future.

Edwardsiella tarda Causing Fishbone Injury Cellulitis Leading to Sepsis in a Case of Hematological Malignancy—A Rare Report and Review of Literature

“…There was one report of soft-tissue infection and sepsis following a catfish bite and one case of deep leg abscess following trauma by the barb of freshwater fish from the United States and one report of bacteremia during chemotherapy for acute lymphoblastic leukemia from Japan ( Table 1 ). 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 So, to the best of our knowledge, the present case is a rare report of E. tarda sepsis following fishbone injury cellulitis in an individual with underlying hematological malignancy.…”

“…Clinical details of all published kinds of literature are compiled in Table 1 . 2 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 As per the review, E. tarda was found to be the cause of various infections such as sepsis, cholangitis, endocarditis, deep abscess, myonecrosis, osteomyelitis, and pelvic inflammatory disease. Out of these, nine were isolated solely from blood, seven from pus/ tissue fluids along with blood, five solely from pus/tissue/fluids, and three from stool.…”

Case Report: Disseminated Edwardsiella tarda infection in an immunocompromised patient

“…E. tarda septicemic presentations tend to occur in patients with underlying hepatobiliary disease, diabetes mellitus, malignancy, and iron overload states, such as sickle cell disease (J Michael Janda and Abbott, 1993 ; Wang et al., 2005 ). Healey and colleagues recently described a rapidly fatal case of E. tarda bacteremia in a patient with advanced lung cancer, pulmonary hypertension, hepatitis C virus, and liver cirrhosis, acquired after the ingestion of raw oysters a day prior to presentation ( Healey et al., 2021 ). Our patient had portal hypertension and congestive hepatopathy that may have contributed to her presenting with bacteremia and SBP.…”

Urinary tract infection caused by Edwardsiella tarda: a report of the first case in Iran

“…Intestinal symptoms such as gastroenteritis are the most frequent manifestations of E. tarda infection [ 15 ]. Although E. tarda is a rare human pathogen, immunocompromised patients and those with subacute or chronic diseases have a higher incidence of extraintestinal infection [ 16 ].…”