Aeromonas sobria sepsis complicated by rhabdomyolysis in an HIV-positive patient: case report and evaluation of traits associated with bacterial virulence

Int J Infect Dis. 2009 May;13(3):e113-8. doi: 10.1016/j.ijid.2008.08.003. Epub 2008 Nov 1.

Abstract

Human infection with Aeromonas species is uncommon and most often due to trauma with exposure to contaminated water or soil. A 43-year-old HIV- and hepatitis C virus (HCV)-infected male, after a two-week course of corticosteroid therapy for an autoimmune anemia, developed diarrhea, dermatologic manifestations and a multiple organ dysfunction syndrome, resulting in death. Although stool samples were repeatedly negative, two sets of blood cultures obtained during a single peak of fever yielded the post-mortem isolation of a Gram-negative, oxidase-positive, beta-hemolytic bacillus that was identified as Aeromonas sobria. Empiric antibiotic therapy was unsuccessful. Evaluation of the virulence-associated traits of the clinical isolate (adhesion, cytotoxicity activity, biofilm production) showed that the strain was a poor producer of recognized virulence factors, thereby indicating that the unfortunate coexistence of HIV infection, HCV-related liver cirrhosis and corticosteroids played a key role in the clinical course.

Publication types

  • Case Reports

MeSH terms

  • Adrenal Cortex Hormones / adverse effects
  • Adult
  • Aeromonas / isolation & purification
  • Aeromonas / pathogenicity*
  • Bacterial Adhesion
  • Bacterial Toxins / analysis
  • Cell Line
  • Fatal Outcome
  • Gram-Negative Bacterial Infections / complications
  • Gram-Negative Bacterial Infections / microbiology*
  • HIV Infections / complications*
  • Hepatitis C, Chronic / complications*
  • Humans
  • Immunocompromised Host
  • Immunosuppressive Agents / adverse effects
  • Male
  • Rhabdomyolysis / complications*
  • Sepsis / complications
  • Sepsis / immunology
  • Sepsis / microbiology*
  • Virulence

Substances

  • Adrenal Cortex Hormones
  • Bacterial Toxins
  • Immunosuppressive Agents