Empyema and bacteremia caused by Aeromonas hydrophila: Case report and review of the literature

  • Nobuhiro Asai
    Affiliations
    Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan

    Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan

    Department of Pathology, University of Michigan, Ann Arbor, MI, USA
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  • Hiroyuki Suematsu
    Affiliations
    Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
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  • Daisuke Sakanashi
    Affiliations
    Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
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  • Hideo Kato
    Affiliations
    Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan

    Department of Pharmacy, Mie University Hospital, Mie, Japan

    Department of Clinical Pharmaceutics, Division of Clinical Medical Science, Mie University Graduate School of Medicine, Mie, Japan
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  • Arufumi Shiota
    Affiliations
    Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
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  • Mao Hagihara
    Affiliations
    Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan

    Department of Molecular Epidemiology and Biomedical Sciences, Aichi Medical University, Aichi, Japan
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  • Yusuke Koizumi
    Affiliations
    Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan

    Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
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  • Yuka Yamagishi
    Affiliations
    Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan

    Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
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  • Hiroshige Mikamo
    Correspondence
    Corresponding author. Department of Clinical Infectious Diseases, Aichi Medical University School of Medicine, 480-1195 1-1 Yazakokarimata, Nagakute, Aichi, Japan.
    Affiliations
    Department of Clinical Infectious Diseases, Aichi Medical University Hospital, Aichi, Japan

    Department of Infection Control and Prevention, Aichi Medical University Hospital, Japan
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Published:January 11, 2022DOI:https://doi.org/10.1016/j.jiac.2021.12.029

      Abstract

      Introduction

      Despite 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 presentation

      A 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.

      Conclusion

      Physicians should be aware of the possibility of acute empyema caused by A. hydrophila among patients with chronic hepatic disease.

      Keywords

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