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Case Reports
. 2023 Feb 1;121(1):e202102448.
doi: 10.5546/aap.2021-02448.eng. Epub 2022 Oct 27.

Meningitis due to carbapenemase-producing Aeromonas hydrophila: a case report

[Article in English, Spanish]
Carolina Vanzo  1 , Shirley Gareis  1 , Andrés Gomila  1 , Sebastián Caliva  2 , Marisa Paredes  2 , Analía Garnero  1
Affiliations
Case Reports

Meningitis due to carbapenemase-producing Aeromonas hydrophila: a case report

[Article in English, Spanish]
Carolina Vanzo et al. Arch Argent Pediatr. .

Abstract
in English, Spanish

Here we describe an unusual clinical presentation of infection due to Aeromonas hydrophila and underline the importance of a correct microbiological diagnosis for an adequate treatment. A 6-year-old patient with a history of craniotomy with duraplasty the week before consulted for fever and drainage of serosanguineous fluid from the surgical wound. The laboratory parameters were normal and the computed tomography scan showed no relevant changes. Lumbar puncture: leukocytes: 91/mm3; proteins: 89 mg/dL; glucose: 36 mg/dL. Treatment with vancomycin and ceftazidime was started. Cerebrospinal fluid culture: oxidase-positive, glucose-fermenting Gram-negative bacillus. Treatment was changed to meropenem. At 72 hours, using a diffusion method and Vitek 2, it was reported as Aeromonas hydrophila sensitive to trimethoprim-sulfamethoxazole, ciprofloxacin, cefotaxime, and meropenem. The Blue-Carba method was performed to detect carbapenemases; the result was positive. Treatment was changed to trimethoprimsulfamethoxazole. The patient completed 21 days of treatment with a favorable clinical course.

Se describe una presentación clínica inusual de infección por Aeromonas complejo hydrophila y se destaca la importancia del correcto diagnóstico microbiológico para adecuar el tratamiento. Paciente de 6 años consultó por fiebre y drenaje de líquido serohemático de herida quirúrgica por antecedente de craneotomía con duroplastia la semana previa. Laboratorio con parámetros normales y tomografía computada sin cambios relevantes. Punción lumbar: leucocitos 91/mm3, proteínas 89 mg/dl, glucosa 36 mg/dl. Comenzó tratamiento con vancomicina y ceftazidima. Cultivo de líquido cefalorraquídeo: bacilo gramnegativo, oxidasa positivo, fermentador de glucosa. Se rotó a meropenem. A las 72 horas, se informó, por método difusión y Vitek2, Aeromonas complejo hydrophila: sensible a trimetoprimasulfametoxazol, ciprofloxacina, cefotaxima y meropenem. Se realizó método Blue Carba para detección de carbapenemasas con resultado positivo. Se rotó a trimetoprima-sulfametoxazol. Completó 21 días de tratamiento con evolución clínica favorable.

Keywords: Aeromonas; beta-lactamase; carbapenemase; meningitis.

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