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Shewanella haliotis associated with severe soft tissue infection, Thailand, 2012.

Poovorawan K, Chatsuwan T, Lakananurak N, Chansaenroj J, Komolmit P, Poovorawan Y - Emerging Infect. Dis. (2013)

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Marine bacteria of the family Shewanellaceae, genus Shewanella, are gram-negative, motile bacilli that grow aerobically or anaerobically and produce hydrogen sulfide... Organisms belonging to a Shewanella species were first isolated in 1931 by Derby and Hammer from dairy products and classified as Achromobacter putrefaciens... Members of Shewanella species usually are found in marine environments in warm climates or during summer in temperate climates... After tissue and blood samples were collected and submitted for microbiological analysis, shock resuscitation and an emergency fasciotomy (Figure, panel B) were performed, and antimicrobial drug treatment with meropenem and vancomycin was started... Surgeons did not confirm the suspected necrotizing fasciitis... Because phylogenetically related Shewanella species may be misidentified by routine biochemical tests, the strain was confirmed by using 16S rRNA gene sequencing... Molecular characterization of 16S rRNA gene sequencing was performed by using PCR with Shewanella species consensus primers (Technical Appendix Table) and direct sequencing from PCR product (JX968803)... The strain was confirmed as S. haliotis by using additional biochemical tests and API 20 NE System (bioMérieux, Durham, NC, USA)... It was positive for ornithine decarboxylase, gelatinase, reduction of nitrates to nitrites, tolerance to 6% NaCl, and assimilation of caprate and malate, but negative for citrate utilization, arginine dihydrolase, lysine decarboxylase, urease, indole production, assimilation of mannose, glucose, arabinose, mannitol, maltose, adipate, and acidification of glucose... Molecular characterization of 16S rRNA gene sequencing can be used to differentiate the 2 species... In summary, this case suggests that immune-compromised persons in tropical climates could be susceptible to S. haliotis soft tissue infection in the absence of typical exposures... Specific Shewanella consensus primer sets for 16S rRNA gene sequencing and phylogenetic analysis.

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Shewanella haliotis severe soft tissue infection of woman in Thailand, 2012. The patient sought treatment for painful erythematous swelling of the left leg. A) Arrow indicates affected area. B) Postsurgical fasciotomy wound with necrotic tissue.
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Figure 1: Shewanella haliotis severe soft tissue infection of woman in Thailand, 2012. The patient sought treatment for painful erythematous swelling of the left leg. A) Arrow indicates affected area. B) Postsurgical fasciotomy wound with necrotic tissue.

Mentions: In September 2012, a 52-year-old woman, living in Bangkok, Thailand, was hospitalized after experiencing drowsiness for 2 hours. She had a low-grade fever, chills, and swelling, erythema, and tenderness in her left leg. During the previous week, she had handled fresh seafood in a market and had eaten cooked mackerel. She denied having eaten uncooked food or wading into flooded areas or the sea. She had undergone orthotopic liver transplantation 6 months previously to excise hepatocellular carcinoma related to Child-Pugh class C hepatitis C cirrhosis; since that procedure, she had been under treatment with immunosupressive drugs. She also had diabetes, hypertension, and nephrotic syndrome. Physical examination revealed that in addition to above-named symptoms, multiple blisters were noted (Figure, panel A). Her oral temperature was 37.8°C, blood pressure 80/40 mm Hg, pulse was 110 bpm, and respiratory rate was 24 breaths/minute. A complete blood count showed a leukocyte count of 2,250 cells/μL (91.2% neutrophils). Despite adequate rehydration, monitored by central venous pressure, the patient required norepinephrine to stabilize her vital signs. The clinical diagnosis of her condition was septic shock with suspected necrotizing fasciitis.


Shewanella haliotis associated with severe soft tissue infection, Thailand, 2012.

Poovorawan K, Chatsuwan T, Lakananurak N, Chansaenroj J, Komolmit P, Poovorawan Y - Emerging Infect. Dis. (2013)

Shewanella haliotis severe soft tissue infection of woman in Thailand, 2012. The patient sought treatment for painful erythematous swelling of the left leg. A) Arrow indicates affected area. B) Postsurgical fasciotomy wound with necrotic tissue.
© Copyright Policy
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC3713828&req=5

Figure 1: Shewanella haliotis severe soft tissue infection of woman in Thailand, 2012. The patient sought treatment for painful erythematous swelling of the left leg. A) Arrow indicates affected area. B) Postsurgical fasciotomy wound with necrotic tissue.
Mentions: In September 2012, a 52-year-old woman, living in Bangkok, Thailand, was hospitalized after experiencing drowsiness for 2 hours. She had a low-grade fever, chills, and swelling, erythema, and tenderness in her left leg. During the previous week, she had handled fresh seafood in a market and had eaten cooked mackerel. She denied having eaten uncooked food or wading into flooded areas or the sea. She had undergone orthotopic liver transplantation 6 months previously to excise hepatocellular carcinoma related to Child-Pugh class C hepatitis C cirrhosis; since that procedure, she had been under treatment with immunosupressive drugs. She also had diabetes, hypertension, and nephrotic syndrome. Physical examination revealed that in addition to above-named symptoms, multiple blisters were noted (Figure, panel A). Her oral temperature was 37.8°C, blood pressure 80/40 mm Hg, pulse was 110 bpm, and respiratory rate was 24 breaths/minute. A complete blood count showed a leukocyte count of 2,250 cells/μL (91.2% neutrophils). Despite adequate rehydration, monitored by central venous pressure, the patient required norepinephrine to stabilize her vital signs. The clinical diagnosis of her condition was septic shock with suspected necrotizing fasciitis.

View Article: PubMed Central - PubMed

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Marine bacteria of the family Shewanellaceae, genus Shewanella, are gram-negative, motile bacilli that grow aerobically or anaerobically and produce hydrogen sulfide... Organisms belonging to a Shewanella species were first isolated in 1931 by Derby and Hammer from dairy products and classified as Achromobacter putrefaciens... Members of Shewanella species usually are found in marine environments in warm climates or during summer in temperate climates... After tissue and blood samples were collected and submitted for microbiological analysis, shock resuscitation and an emergency fasciotomy (Figure, panel B) were performed, and antimicrobial drug treatment with meropenem and vancomycin was started... Surgeons did not confirm the suspected necrotizing fasciitis... Because phylogenetically related Shewanella species may be misidentified by routine biochemical tests, the strain was confirmed by using 16S rRNA gene sequencing... Molecular characterization of 16S rRNA gene sequencing was performed by using PCR with Shewanella species consensus primers (Technical Appendix Table) and direct sequencing from PCR product (JX968803)... The strain was confirmed as S. haliotis by using additional biochemical tests and API 20 NE System (bioMérieux, Durham, NC, USA)... It was positive for ornithine decarboxylase, gelatinase, reduction of nitrates to nitrites, tolerance to 6% NaCl, and assimilation of caprate and malate, but negative for citrate utilization, arginine dihydrolase, lysine decarboxylase, urease, indole production, assimilation of mannose, glucose, arabinose, mannitol, maltose, adipate, and acidification of glucose... Molecular characterization of 16S rRNA gene sequencing can be used to differentiate the 2 species... In summary, this case suggests that immune-compromised persons in tropical climates could be susceptible to S. haliotis soft tissue infection in the absence of typical exposures... Specific Shewanella consensus primer sets for 16S rRNA gene sequencing and phylogenetic analysis.

Show MeSH
Related in: MedlinePlus