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Edema, cyanosis, and dusky purplish discoloration with necrotic tense blisters on the right upper extremity.
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Figure 1: Edema, cyanosis, and dusky purplish discoloration with necrotic tense blisters on the right upper extremity.

Mentions: Physical examination revealed slightly icteric sclera and edema, cyanosis, and dusky purplish discoloration with necrotic tense vesicobullous lesions on the right arm (Fig. 1). She became comatose while being transferred from a private clinic to our hospital. Her pupils were completely dilated, and her blood pressure could not be checked because of low pressure. She was in a state of cardiopulmonary arrest. After approximately 30 minutes of active cardiopulmonary resuscitation and medical therapy for treatment of shock, her vital signs became stabilized. After 40 minutes, we started intravenous injection of ampicillin and cephalosporin. However, she died at 1 hour after administration of antibiotic therapy.

Aeromonas hydrophila Sepsis Mimicking Vibrio vulnificus Infection

Park SY, Nam HM, Park K, Park SD - Ann Dermatol (2011)

Bottom Line: Despite all efforts to save the patient, she died 8 hours after admission.Clinical features of A. hydrophila sepsis resemble those of Vibrio vulnificus sepsis.Therefore, in addition to the case report, we compared the cultural, biochemical, and morphological differences between A. hydrophila and V. vulnificus for facilitation of early and accurate identification of the causative agent.

Affiliation: Department of Dermatology, Wonkwang University School of Medicine, Iksan, Korea.

ABSTRACT
Aeromonas hydrophila is a facultatively anaerobic, asporogenous gram-negative rod that has often been regarded as an opportunistic pathogen in hosts with impairment of a local or general defense mechanism. A 68-year-old alcoholic woman presented with shock and gangrene on the right arm. At first, her clinical presentations were severe painful erythematous swelling that worsened within a few hours with development of gangrene, edema, and blisters. Bullous fluid and blood cultures yielded A. hydrophila. Histopathological findings of sections obtained from the vesicle revealed subepidermal vesicles; necrosis of the epidermis, papillary dermis, and subcutaneous fat; and massive hemorrhage in the subcutis. Despite all efforts to save the patient, she died 8 hours after admission. Clinical features of A. hydrophila sepsis resemble those of Vibrio vulnificus sepsis. Therefore, in addition to the case report, we compared the cultural, biochemical, and morphological differences between A. hydrophila and V. vulnificus for facilitation of early and accurate identification of the causative agent.

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