Nongastrointestinal Aeromonas hydrophila Infections in Patients With Cancer

Abstract

Aeromonas hydrophila is an aquatic bacterium that causes sporadic, opportunistic warm-weather soft tissue infections and bacteremias, classically among men with predisposing liver disorders or leukemias. Although the portal of entry often remains elusive, the end result in these immunodeficient populations can be devastating.At our institution, we exhaustively reviewed patient charts and records and identified A. hydrophila from fluid specimens in 24 symptomatic patients with cancer over a period of 23 years. Seven of our patients were male and the other 17 patients were female, and the median age was 64 years.Predisposing conditions were identified as follows: Six of them had solid organ malignancies, and two had a diagnosis of hematologic malignancies; four patients had altered hepatic function, whereas 3 patients had neutropenia. Only one patient was found to have the classical risk factor of liver cirrhosis, in this case, secondary to chemotherapy.The 2 patients exhibiting soft tissue manifestations of Aeromonas acquired the bacterium in the community and presented with local abscess and fever. Only one of the 2 patients gave a history of fresh water exposure. We successfully managed these 2 patients with nonsurgical intervention.

Necrotizing Fasciitis Secondary to Aeromonas Infection Presenting with Septic Shock

“…As discussed previously, hepatic dysfunction is an underlying risk factor for septic shock in Aeromonas infection. The liver is responsible for the production of thrombopoietin, a hormone that helps regulate platelet production in bone marrow [ 10 ]. Platelets are involved in the release of cytokines that mediate inflammatory responses.…”