Aeromonas hydrophila sepsis presenting as meningitis and necrotizing fasciitis in a man with alcoholic liver cirrhosis

Abstract

Aeromonas hydrophila is rarely reported as a causative organism of meningitis in humans. A 39-year-old man with alcoholic liver cirrhosis was admitted with a 2-day history of fever, chills, and confusion. Laboratory data revealed leukocytosis with granulocytosis, marked impairment of renal and liver function, and an elevated serum ammonia level. A. hydrophila was isolated from both blood and cerebrospinal fluid samples. Skin and soft-tissue lesions, consisting of bullae and necrotizing fasciitis, were found in the lower left leg 2 days after admission. Cultures of the bullous fluid, subcutaneous tissue, and fascia all yielded A. hydrophila. Pathologic examination revealed extensive necrosis. Although the patient was appropriately managed with antibiotics, debridement, and fasciotomies, his clinical status rapidly deteriorated, resulting in death 3 days after admission.