Edwardsiella tarda Bacteremia with Psoas and Epidural Abscess as a Food-borne Infection: A Case Report and Literature Review

Recurrent cholangitis and bacteraemia due to Edwardsiella tarda: a case report

Edwardsiella tarda is typically isolated from aquatic environments. It rarely causes infections in humans. Edwardsiella tarda infections in humans result from the consumption of infected or contaminated food. Here, we present a case of recurrent cholangitis and bacteraemia associated with E. tarda. An 82-year-old man with no history of seafood inoculation was admitted to our hospital because of difficulty in moving his body. The patient was diagnosed with cholangitis, and the blood culture revealed the presence of E. tarda. The patient underwent bile duct stenting and received antibiotic therapy for 14 days. Forty-four days after discharge, cholangitis recurred, and blood culture again showed the presence of E. tarda. The patient underwent bile duct stenting and antibiotic therapy for 11 days. No cholangitis or bacteraemia associated with E. tarda was observed in the following 3 years. Our case strongly suggests that colonization with E. tarda results in recurrent cholangitis and bacteraemia.

Edwardsiella tarda Causing Fishbone Injury Cellulitis Leading to Sepsis in a Case of Hematological Malignancy-A Rare Report and Review of Literature

Edwardsiella tarda ( E. tarda ), a gram-negative bacillus, a member of order Enterobacterales , is typically a fish pathogen frequently isolated from fresh and brackish water environments. It is very rarely implicated in human infections such as gastroenteritis (most common), cellulitis, gas gangrene, hepatobiliary infections, peritonitis, empyema, and meningitis. Bacteremia/sepsis caused by E. tarda can be fatal in humans, although very rare (<5%). To date, very few cases of E. tarda sepsis have been reported worldwide including India. We report a rare case of cellulitis caused by E. tarda following fishbone injury in a patient with underlying hematological malignancy leading to sepsis.

Case Report: Disseminated Edwardsiella tarda infection in an immunocompromised patient

Human infection caused by bacteria of the Edwardsiella genus is rare and most often presents with gastroenteritis that rarely requires antibiotics. Our case report describes a medically complex patient with chronic steroid use contributing to an immunocompromised state, who presented with fever and abdominal pain. The patient was later found to have Edwardsiella tarda (E. tarda) bacteremia and underwent paracentesis confirming E. tarda bacterial peritonitis requiring a prolonged antibiotic course. This case report aims to illustrate the presentation, diagnosis, and management of an uncommon infection that can have severe complications especially among immunocompromised patients.

Edwardsiella tarda in Tambaqui (Colossoma macropomum): A Pathogenicity, Antimicrobial Susceptibility, and Genetic Analysis of Brazilian Isolates

Edwardsiella tarda is a crucial pathogenic bacterium in tropical aquaculture. This bacterium was recently isolated from tambaqui (Colossoma macropomum), a commercially important fish species in Brazil. This study assessed the antimicrobial susceptibility, pathogenicity, and genetic diversity of the tambaqui-derived E. tarda isolates. Fourteen bacterial isolates isolated from tambaqui were identified as E. tarda by using matrix-assisted laser desorption/ionization-time-of-flight mass spectrometry and dnaJ gene sequencing. Antimicrobial susceptibility tests were conducted against seven drugs using the disc diffusion assay. The pathogenicity test conducted by intraperitoneal injection of 2.4 × 107 colony-forming units (CFU) fish-1 of E. tarda (ED38-17) into tambaqui juveniles eventually revealed that neither clinical signs nor death were present. However, splenomegaly and whitish areas in the spleen and kidneys were observed. The histological investigation also revealed granulomatous splenitis, nephritis, and hepatitis occurring internally. Repetitive extragenic palindromic-PCR fingerprinting separated the 14 isolates into three genetic groups. The antibiogram revealed that all E. tarda isolates were wild-type (WT) to florfenicol (FLO), norfloxacin (NOR), neomycin (NEO), erythromycin (ERY), and oxytetracycline (OXY); however, some were non-wild-type to sulfamethoxazole/trimethoprim (7.1%) and amoxicillin (21.4%). Therefore, through experimental infection, E. tarda ED38-17 could induce pathogenic effects in C. macropomum. Additionally, three distinct genetic types were found, and the E. tarda isolates were WT to FLO, NOR, NEO, ERY, and OXY. These findings raise awareness of a bacteria causing unseen lesions, a pathogen that will potentially impact tambaqui aquaculture in the future.

Urinary tract infection caused by Edwardsiella tarda: a report of the first case in Iran

BCKGROUND

Edwardsiella tarda, an Enterobacteriaceae family member, is prevalent in different aquatic settings and rarely infects humans. As a result of eating raw or undercooked seafood, humans become infected through their intestinal tracts. Extraintestinal infections have been reported infrequently, mostly in immunocompromised and chronically ill patients.

CASE PRESENTATION

Our report describes a case of urinary tract infection caused by E. tarda in a 4-year-old female patient with a history of urinary tract infection and a complaint of fever, dysuria, and frequency. E. tarda was identified as the pathogen isolated from the urine culture. The patient's symptoms were alleviated after receiving ceftriaxone and then nitrofurantoin.

CONCLUSION

This case demonstrates that even in immunocompetent patients, E. tarda can infect extraintestinal organs, including urinary tract. Our patient represents the first case of E. tarda infection in Iran and due to the fact that this pathogen is transmitted by aquatic animals, there is a possibility of infecting more aquatic animals and humans in Iran; therefore, the necessary precautions should be taken.

A case report and review of acute cholangitis with septic shock induced by Edwardsiella tarda

BACKGROUND

Edwardsiella tarda (E. tarda) is a gram-negative facultative anaerobic bacterium. Gastroenteritis is the most common manifestation of E. tarda infection. However, parenteral infections can occur in immunodeficient hosts, as well as hepatobiliary diseases, malignancies, and/or diabetes. The prognosis of sepsis caused by E. tarda is very worse, with a mortality rate of 38%. We report the occurrence of acute cholecystitis with septic shock and E. tarda bloodstream infection.

CASE PRESENTATION

A 64-year-old male with acute cholecystitis secondary to hepatitis B virus infection showed fever and sudden upper abdominal pain. On arrival, right upper abdominal pain, nausea, vomiting, fever, and jaundice were observed. Computed tomography showed common bile duct stones and gallbladder stones. Choledocholithiasis with acute cholangitis was diagnosed and treated surgically. Due to septic shock, a blood culture was assessed showing E. tarda as the main pathogen. Choledocholithotomy, T-tube drainage, cholecystectomy, and intravenous antibiotic treatment after the operation. The patient recovered smoothly after the operation.

CONCLUSIONS

Although E. tarda infection is extremely rare, it can cause rapid episodes of rapidly progressive and life-threatening disease, as well as intestinal and parenteral infections. If necessary, early surgical treatment of parenteral infection should be considered and antibiotics should be used in time.

Spontaneous bacterial peritonitis caused by Edwardsiella tarda: A case report

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Case of spontaneous bacterial peritonitis associated with E. tarda infection.

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The patient had Child–Pugh A cirrhosis secondary to hepatitis C virus infection.

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Surgical findings included redness and thickening of the cecal wall.

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Purulent ascites without intestinal contents was observed.

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E. tarda infection has a poor prognosis in patients with underlying disease.

Introduction

Edwardsiella tarda is a member of the Enterobacteriaceae family of gram-negative bacilli isolated from animals. Gastroenteritis is the most common manifestation of E. tarda infection. However, extraintestinal infections can occur in immunocompromised hosts as well as patients with hepatobiliary disease, malignancy, and/or diabetes mellites. The prognosis of sepsis caused by E. tarda is extremely poor, with a mortality rate of 38%. Here we report the occurrence of spontaneous bacterial peritonitis associated with E. tarda infection.

Presentation of case

An 87-year-old man with Child–Pugh A cirrhosis secondary to hepatitis C virus infection presented with diarrhea and sudden-onset pain in the abdomen. On arrival, guarding and rebound tenderness were observed over the entire abdomen. Computed tomography revealed circumferential thickening of the cecum and a small volume of ascites in the pelvic cavity. A diagnosis of peritonitis was made, and surgery was performed. Surgical findings included redness and thickening of the cecal wall and purulent ascites without intestinal contents. Peritoneal fluid culture revealed E. tarda as the sole pathogen. The abdominal cavity was washed, a drain was placed in the pelvic cavity, and postoperative intravenous antibiotic therapy was initiated. The postoperative course was uneventful.

Discussion

E. tarda infection in the presence of an underlying disease such as hepatobiliary disease, malignancy, and/or diabetes mellitus has a poor prognosis.

Conclusion

Although E. tarda infection is extremely rare, it is a life-threatening illness that can cause intestinal and extraintestinal infections. If necessary, early surgical intervention should be considered for cases of extraintestinal infection.

Gastric submucosal abscess caused by Edwardsiella tarda infection: a case report

Background

Edwardsiella tarda is a motile, facultatively anaerobic gram-negative bacillus that is isolated from a wide spectrum of animals in aquatic environments but rarely causes infection in humans. Here, we describe the case of a gastric submucosal abscess caused by E. tarda infection.

Case presentation

The patient was a 74-year-old man with a history of hypertension and chronic alcohol consumption who was admitted to our hospital for abdominal pain, appetite loss and vomiting. Contrast-enhanced computed tomography (CT) revealed choledocholithiasis in the common bile duct, a gastric wall abscess and an intra-abdominal abscess. Endoscopic ultrasound (EUS)-guided drainage with antibiotics successfully cured the patient.

Conclusion

The combination of CT, endoscopy and EUS-guided drainage with antibiotic therapy might be effective for diagnosis and treatment of a gastric submucosal abscess caused by E. tarda infection.

Fulminant septic shock due to Edwardsiella tarda infection associated with multiple liver abscesses: a case report and review of the literature

INTRODUCTION

Edwardsiella tarda uncommonly infects humans. The usual presentation is mild gastroenteritis, but systemic manifestations may occur. Lethal infections are rarely documented in patients with underlying disorders.

CASE PRESENTATION

A previously healthy 37-year-old Southeast Asian woman presented to our hospital with recent onset of abdominal pain, fever, and vomiting. Her condition rapidly deteriorated with signs and symptoms of fulminant septic shock; thus, she was intubated, supported with intravenous vasopressors and fluids, and transferred to the intensive care unit. An abdominal computed tomographic scan with contrast revealed multiple liver abscesses. Blood cultures were obtained and computed tomography-guided percutaneous drainage of the liver abscesses with supplementary cultures was performed; thereafter, empirical broad-spectrum antibiotics were initiated. All cultures grew E. tarda, whereas an antibiogram showed resistance to broad-spectrum antibiotics and sensitivity to ciprofloxacin and aminoglycosides; thus, the antibiotic regimen was updated accordingly. The patient made an uneventful recovery and was discharged from the intensive care unit 14 days after admission.

CONCLUSION

E. tarda human infection can present as liver abscess and fulminant septic shock. E. tarda strains can be resistant to broad-spectrum antibiotics; hence, culture-based antibiotics should be used accordingly. Clinicians should be aware of this rare and potentially lethal infection.

Scombroid Poisoning with Concurrent Brevundimonas Septicemia: A Unique Case Report and Brief Literature Review

Scombroid poisoning is a predominantly self-limited illness associated with ingestion of poorly handled fish. It is not frequently associated with bacteremia and has never been described with Brevundimonas septicemia. We describe a case of a man who presented in shock with histamine poisoning after ingesting sushi. Blood cultures grew an uncommon pathogen, Brevundimonas vesicularis. This case demonstrates systemic bacterial infection in the setting of histamine poisoning, which is an atypical presentation for a well-known foodborne illness.

Next generation sequencing-guided anti-infective therapy of large liver abscess due to Edwardsiella tarda: a case report

Background

Liver abscess is a potentially fatal disease, however identification of its causative pathogen remains challenging, which is crucial for guiding appropriate antibiotic therapy. To the best of our knowledge, the use of plasma next-generation sequencing (NGS) based pathogen analysis in patients with liver abscess has never been reported.

Case presentation

We report a case with large liver abscess due toEdwardsiella tardathat was diagnosed by the plasma-based NGS assay within 24 h. After a 2-week single agent anti-infection therapy, the patient completely recovered. A second NGS assay following anti-infection therapy failed to detect the pathogenic DNA. Follow-up magnetic resonance imaging (MRI) of the abdomen on 1 month and 3 months showed a gradually decrease in size of the liver abscess, and the 6-month MRI showed that the abscess disappeared completely.

Conclusions

Our data indicated that the plasma NGS test can sensitively and minimal-invasively detect pathogens within a clinically actionable timeframe, and antibiotic alone is an alternative to first-line treatment for large liver abscess with the aid of NGS for accurate detection of the pathogenic bacterial genome.

The Edwardsiella piscicida Type III Effector EseJ Suppresses Expression of Type 1 Fimbriae, Leading to Decreased Bacterial Adherence to Host Cells

The type III secretion system (T3SS) of Edwardsiella piscicida plays a crucial role in its pathogenesis. Our previous study indicated that the T3SS effector protein EseJ inhibits the bacterium's adhesion to epithelioma papillosum cyprini (EPC) cells, while the mechanism of the inhibition remains elusive. In this study, we revealed that EseJ negatively regulates the fimA gene, as demonstrated by comparative transcription analysis of ΔeseJ and wild-type (WT) strains. As well, the dramatically increased production of FimA was detected in the absence of EseJ compared to that by the WT strain. The adherence of the ΔeseJ strain decreased far below that of the WT strain in the absence of FimA, demonstrating that FimA plays a pivotal role in the hyperadhesion of the ΔeseJ strain. Adherence analysis with a strain with truncated eseJ demonstrated that the C-terminal region of EseJ (Gly1191 to Ile1359) is necessary to inhibit the transcription of the type 1 fimbrial operon. Binding between the EseJ fragment from amino acid residues 1191 to 1359 and the DNA fragment upstream of fimA was not detected, indicating that EseJ might indirectly regulate the type 1 fimbrial operon. Our study reveals that EseJ controls E. piscicida adherence to EPC cells by negatively regulating the type 1 fimbrial operon.