Case Report: Disseminated Shewanella algae Infection with Meningoencephalitis in a Traveler Secondary to Marine Injury in Madagascar

Am J Trop Med Hyg. 2017 Oct;97(4):1043-1044. doi: 10.4269/ajtmh.17-0175. Epub 2017 Jul 19.

Abstract

Marine microorganisms such as Shewanella spp., Vibrio spp., and Aeromonas spp. can cause sepsis secondary to a wound infection in the context of swimming. These microorganisms are most often susceptible to fluoroquinolones. Here, we report a unique case of Shewanella algae bacteremia associated with meningoencephalitis and disseminated via hematogenous spread secondary to a skin injury. The patient suffered the injury while swimming in saline water during a cruise holiday in Madagascar, and she was initially treated with amoxicillin. The neurological evolution was unsatisfactory. Better knowledge of such infections (and especially of the context in which they occur), as well as greater familiarity with the susceptibility profile of different marine microorganisms would have allowed health professionals to provide presumptive microbiological diagnosis and effective treatment earlier.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Amoxicillin / therapeutic use*
  • Animals
  • Anti-Bacterial Agents / therapeutic use*
  • Female
  • Gram-Negative Bacterial Infections / complications*
  • Gram-Negative Bacterial Infections / diagnosis
  • Gram-Negative Bacterial Infections / drug therapy*
  • Humans
  • Madagascar
  • Meningoencephalitis / diagnosis
  • Meningoencephalitis / drug therapy*
  • Meningoencephalitis / etiology*
  • Seawater / microbiology
  • Sepsis / drug therapy
  • Sepsis / etiology
  • Shewanella / drug effects
  • Swimming
  • Travel
  • Treatment Outcome
  • Wound Infection / drug therapy
  • Wound Infection / etiology
  • Wounds and Injuries / complications*
  • Wounds and Injuries / drug therapy

Substances

  • Anti-Bacterial Agents
  • Amoxicillin