Extraintestinal manifestations of Edwardsiella tarda infection: a 10-year retrospective review

Abstract

Edwardsiella tarda, a member of the family Enterobacteriaceae found in aquatic environments, is an unusual cause of human disease, presenting most frequently as gastroenteritis. Extraintestinal manifestations of E. tarda infection are rare but have included meningitis, cholecystitis, endocarditis, osteomyelitis, soft tissue infections, bacteremia, and septicemia. Over a 10-year period at our institution, 10 cases of extraintestinal infection related to E. tarda were identified. The infections ranged from soft tissue infections secondary to trauma to intra-abdominal infections with abscess formation. Several of the patients had documented factors predisposing them to infection including diabetes mellitus and C1 esterase deficiency. Interestingly, two of the patients had chronic idiopathic inflammatory bowel disease, and one patient developed a respiratory tract infection related to E. tarda, a previously unreported clinical manifestion. Although the mortality rate for extraintestinal E. tarda infections has been as high as 50% in some studies, antimicrobial treatment was eventually successful in each of the 10 cases at our institution.