Skin and Soft Tissue Infections (Patera Foot) in Immigrants, Spain

Vega, Hugo Guillermo Ternavasio-de la; Ángel-Moreno, Alfonso; Hernández-Cabrera, Michele; Pisos-Álamo, Elena; Bolaños-Rivero, Margarita; Carranza-Rodríguez, Cristina; Calderín-Ortega, Antonio; Pérez-Arellano, José-Luis

doi:10.3201/eid1504.081457

Cited by 20 publications

(14 citation statements)

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“…In fact, a condition termed ‘patera foot’ has been coined to describe Shewanella skin and soft-tissue infections in the lower limbs of these patients, likely from a pre-existing skin lesion that comes into contact with contaminated water. Those patients were generally young, with a good health status before travelling [ 45 ]. Infections, caused by S. algae in 66.7 % of the patients, were very aggressive, involving cellulitis, abscesses and necrosis.…”

Section: Discussionmentioning

confidence: 99%

Shewanella spp. infections in Gran Canaria, Spain: retrospective analysis of 31 cases and a literature review

et al. 2017

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IntroductionShewanella spp. can cause severe skin and soft-tissue infections, gastrointestinal infections, otitis and bacteraemia, generally upon contact with seawater or consumption of raw seafood. Recently, a new condition termed ‘patera foot’ characterized by acute skin and soft-tissue infection has been described in irregular immigrants arriving to the Canary Islands, Spain, in rudimentary boats. Most infections are caused by a single species, Shewanella algae. The improvement of the diagnostic capabilities in clinical microbiology laboratories has resulted in a growing number of cases being reported worldwide, most of them coming from warm regions.Case presentationIn this work, we reviewed the medical records of all the patients with Shewanella infections in the two university hospitals of Gran Canaria (the Canary Islands, Spain) during the period 2000–2016, resulting in the identification of 31 cases. We also conducted a literature review of Shewanella infections reported worldwide in recent years.ConclusionThis case series suggests that Shewanella infections are nosocomially acquired more frequently than previously thought. In addition, the unexpectedly high proportion of multidrug-resistant isolates raises concerns.

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Section: Discussionmentioning

confidence: 99%

Shewanella spp. infections in Gran Canaria, Spain: retrospective analysis of 31 cases and a literature review

et al. 2017

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“…Human infections with Shewanella spp. are unusual and have a restricted geographic distribution with most cases being reported from areas with warm climates like Southeast Asia [59][60][61][62][63], southern Europe [64][65][66], South Africa [67,68], or from countries with temperate climate in especially warm summers [69]. The only Shewanella spp.…”

Section: Shewanella Sppmentioning

confidence: 99%

“…In a review of 27 cases of Shewanella SSTIs [60], 22 patients (81.5%) had limb involvement and in 18 the infection involved the lower limbs. Shewanella cellulitis often has a protracted course [60,66,79], but more severe infections like necrotizing fasciitis [61], bacteremia, particularly in patients with severe underling conditions [60,[63][64][65] and fulminant cases [60] have also been described. Shewanella spp.…”

Section: Shewanella Sppmentioning

confidence: 99%

Soft Tissue Infections Caused by Marine Bacterial Pathogens: Epidemiology, Diagnosis, and Management

Finkelstein

Oren

2011

Curr Infect Dis Rep

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Skin and soft tissue infections (SSTIs) are one of the most common infection syndromes and may be caused by a large number of microorganisms. Some principles of aquatic injuries are different than those of land-based trauma. Wounds sustained in marine environment are exposed to a milieu of bacteria rarely encountered in different settings. These include Vibrio spp., Aeromonas spp., Shewanella spp., Erysipelothrix rhusiopathiae, Mycobacterium marinum, Streptococcus iniae, and other microbes. Failure to recognize and treat these uncommon pathogens in a timely manner may result in significant morbidity or death. These infections are frequently contracted as a result of recreational swimming, fishing injuries, or seafood handling. The spectrum of manifestations is wide, varying from cases of mild cellulitis, to severe life-threatening necrotizing fasciitis requiring radical surgery, to sepsis and death. This review will focus on the epidemiology, clinical manifestations, and treatment of SSTIs caused by the most important marine pathogens.

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“…It has been described in migrants from Africa to Spain traveling in small fishing boats called “pateras,” caused by Gram‐negative organisms including Shewanella species. These infections are suspected to arise after prolonged contact with contaminated water in individuals who have been forced to sit for hours and have been observed in otherwise healthy individuals 94 …”

Section: Skin Health Influenced By Environmental Factorsmentioning

confidence: 99%

Skin diseases in displaced populations: a review of contributing factors, challenges, and approaches to care

2020

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There are 70.8 million persons displaced worldwide due to war, persecution, and violence. Eighty percent of displaced persons reside in low-and middle-income countries with limited healthcare resources. Cutaneous diseases are commonly reported among displaced persons owing to numerous interrelated factors such as inadequate housing, overcrowding, food insecurity, environmental exposures, violence including torture, and breakdown of healthcare infrastructure. Diagnosis and management of these conditions, as well as an understanding of the context in which they present, is crucial to providing dermatologic care for displaced populations worldwide. Herein, we define displaced populations and, within this context, review the epidemiology of skin diseases, discuss pertinent skin conditions, examine challenges to care provision, and present approaches for improving dermatologic care. Inflammatory and communicable infectious disorders are the most common skin diseases seen in displaced populations. Other relevant conditions include skin manifestations of heat injuries, cold injuries, immersion foot syndromes, macronutrient and micronutrient deficiencies, torture, and sexual and gender-based violence. Provision of dermatologic care to displaced populations is hampered by limited diagnostic and therapeutic resources and specialist expertise. Medical screening for cutaneous disorders, context-relevant dermatology training, and telemedicine are potential tools to improve diagnosis and management of skin diseases in displaced populations. (UNHCR) estimates that nearly one person every 2 seconds escapes war, persecution, or terror, leaving everything behind. About 80% of refugees are hosted in low-and middle-income countries, which provide, for example, protection and space for refugee camps and for which the presence of large numbers of refugees brings a significant strain on the infrastructure. 2 Among the nearly 26 million refugees in 2018, 57% came from three countries: Syria (6.7 million), Afghanistan (2.7 million), and South Sudan (2.3 million). 1 Their neighbors, Turkey (3.7 million), Pakistan (1.4 million), Uganda (1.2 million), and Sudan (1.1 million), are among the top refugee hosting countries. 1 Ongoing crises worldwide have led to internal displacement of 4.3 million people in Yemen, 3 flight of 742,000 Rohingya from Myanmar to Bangladesh where many find themselves stateless, 4 and departure of an estimated 4 million Venezuelans 5 to other Latin American countries. Countries in sub-Saharan Africa host greater than 26% of the world's refugees. 6 Less than 1% of refugees transfer from the host country to a third country that has agreed to admit them for permanent resettlement. 7 For displaced persons, inadequate housing, overcrowding, food insecurity, environmental exposures, violence, and poor access to health care are constant threats to achieving and maintaining health. Cutaneous diseases are commonly encountered problems in displaced populations. Diagnosis and management of these conditions, as well as an under...

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Skin and Soft Tissue Infections (Patera Foot) in Immigrants, Spain

Cited by 20 publications

References 14 publications

Shewanella spp. infections in Gran Canaria, Spain: retrospective analysis of 31 cases and a literature review

Shewanella spp. infections in Gran Canaria, Spain: retrospective analysis of 31 cases and a literature review

Soft Tissue Infections Caused by Marine Bacterial Pathogens: Epidemiology, Diagnosis, and Management

Skin diseases in displaced populations: a review of contributing factors, challenges, and approaches to care

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