Empyema and bacteremia caused by Aeromonas hydrophila: Case report and review of the literature |
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| Affiliation: | 1. Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan;2. Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan;3. Department of Pathology, University of Michigan, Ann Arbor, MI, USA;4. Department of Pharmacy, Mie University Hospital, Mie, Japan;5. Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan;6. Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Aichi, Japan;1. Basaksehir Cam and Sakura City Hospital, Department of Pediatric Hematology- Oncology, Turkey;2. Istanbul University, Istanbul Faculty of Medicine, Department of Pediatrics, Division of Pediatric Emergency, Turkey;3. Gaziantep University, Faculty of Medicine, Department of Hematology, Turkey;4. Istanbul University, Istanbul Faculty of Medicine, Department of Medical Biology and Genetics, Turkey;5. University of Health Science, Istanbul Training and Research Hospital, Department of Department of Hematology, Turkey;1. Division of General Pediatrics, Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan;2. Division of Pediatric Infectious Diseases, Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan;3. Department of Pediatrics, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan;4. Department of Otorhinolaryngology, Hyogo Prefectural Amagasaki General Medical Center, Hyogo, Japan;1. Department of Internal Medicine, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan;2. Department of Infectious Diseases, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan;3. Clinical Research Center, National Hospital Organization Kinki-Chuo Chest Medical Center, Osaka, Japan;1. Department of Infectious Diseases, Kyoto City Hospital, Kyoto, Japan;2. Department of Clinical Laboratory Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan;3. Department of Respiratory Medicine, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan;4. Department of Otolaryngology, Kyoto City Hospital, Kyoto, Japan;5. Department of Respiratory Medicine and Infectious Disease, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan;1. Department of Pediatrics and Child Health, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan;2. Department of Obstetrics and Gynecology, Nihon University School of Medicine, 30-1 Oyaguchikamicho, Itabashi-ku, Tokyo, 173-8610, Japan;3. Department of Neonatology, Hyogo Prefectural Kobe Children''s Hospital, 1-6-7, Minatojima-Minamimachi, Chuo-ku, Kobe, 650-0047, Japan;4. Department of Pediatrics, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan;5. Department of Obstetrics and Gynecology, Kobe University Graduate School of Medicine, 7-5-1, Kusunoki-cho, Chuo-ku, Kobe, 650-0017, Japan;6. Center for Recurrent Pregnancy Loss, Teine Keijinkai Hospital, 1-40, Maeda 1-jho, 12-chome, Teine-ku, Sapporo, 006-8555, Japan;7. Department of Immunoparasitology, Research Institute for Microbial Diseases, Osaka University, 3-1, Yamadaoka, Suita, Osaka, 565-0871, Japan;1. The University of Tokyo Hospital, Department of Infectious Diseases, Tokyo, Japan;2. Tokyo Metropolitan Institute of Public Health, Tokyo, Japan |
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| Abstract: | IntroductionDespite the advance in antibiotics and widespread chest tube drainage, acute empyema still shows a high mortality rate, accounting for 10–25%. We experienced a case of acute empyema caused by A. hydrophila, which is extremely uncommon, and reviewed all previously published articles.Case presentationA 76-year older man with a medical history of liver cirrhosis (LC) due to chronic hepatitis C and hepatic cell carcinoma was admitted to our institute. Elevated inflammatory reaction and effusions on chest CT were seen, and he was suspected of having acute empyema. Although an empiric antibiotic therapy of meropenem with chest tube drainage was performed as an initial treatment, he died within 8 hours of admission. Postmortem, both blood and left pleural fluid cultures yielded Aeromonas hydrophila. The final diagnosis was acute empyema caused by A. hydrophila. We reviewed previously reported empyema caused by Aeromonas species cases (4 A. hydrophila, and 1 A. veronii) in 4 previous reports written in English, including ours. Of 5, all were male, and the mean age was 52 years (range 27–76 years). All patients had LC due to alcohol or viral infections. As for antibiotics initially prescribed, third-generation cephalosporins were most frequently used in 3/5 (60%). Thoracentesis was performed in all patients (100%). As for prognosis, 2 (40%) survived, and 3 (60%) died.ConclusionPhysicians should be aware of the possibility of acute empyema caused by A. hydrophila among patients with chronic hepatic disease. |
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| Keywords: | Empyema Gut dysbiosis Liver cirrhosis Bacterial translocation Spontaneous bacterial peritonitis |
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