Infect Chemother.  2012 Jun;44(3):193-196. 10.3947/ic.2012.44.3.193.

A Case of Shewanella algae Bacteremia Accompanying Cellulitis in Both Legs of a Patient on Hemodialysis: Case Report and Literature Review

Affiliations
  • 1Department of Internal Medicine, Seoul Medical Center, Seoul, Korea. dasole@daum.net
  • 2Department of Diagnostic Laboratory Medicine, Seoul Medical Center, Seoul, Korea.

Abstract

We report a fatal case of Shewanella algae bacteremia accompanied by cellulitis in both legs of a chronic renal failure patient who had not been exposed to sea water or raw fish. A 47-year-old male on hemodialysis was admitted to our clinic due to pain in both legs accompanied by a febrile sensation that started 2 days prior to his visit. A blood culture specimen revealed S. algae, a rare human opportunistic pathogen. In spite of early and appropriate antimicrobial treatment, the patient died of septic shock on the second day of his hospital stay. Recently, serious infections caused by Shewanella species have been reported in increasing frequency. Hepatobiliary diseases have been proposed as predisposing factors, not only for infection by this organism, but also for fatality. However, we should be aware of the significance of S. algae in patients with renal insufficiency, especially those on maintenance hemodialysis. Herein, we report our case with review relevant literature.

Keyword

Shewanella algae; Bacteremia; Cellulitis; Renal insufficiency

MeSH Terms

Bacteremia
Cellulitis
Humans
Kidney Failure, Chronic
Leg
Length of Stay
Male
Middle Aged
Renal Dialysis
Renal Insufficiency
Seawater
Sensation
Shewanella
Shock, Septic

Cited by  1 articles

A Case of Spontaneous Bacterial Peritonitis with Bacteremia Caused by Shewanella algae
Bo Kyoung Kim, Sung-Yeon Cho, Borami Kang, Il-Kyu Kim, Ji-Hyun Byun, Chulmin Park, Su-Mi Choi
Infect Chemother. 2014;46(4):264-268.    doi: 10.3947/ic.2014.46.4.264.


Reference

1. Bulut C, Ertem GT, Gökcek C, Tulek N, Bayar MA, Karakoc E. A rare cause of wound infection: Shewanella putrefaciens. Scand J Infect Dis. 2004. 36:692–694.
2. Holt HM, Gahrn-Hansen B, Bruun B. Shewanella algae and Shewanella putrefaciens: clinical and microbiological characteristics. Clin Microbiol Infect. 2005. 11:347–352.
Article
3. Otsuka T, Noda T, Noguchi A, Nakamura H, Ibaraki K, Yamaoka K. Shewanella infection in decompensated liver disease: a septic case. J Gastroenterol. 2007. 42:87–90.
Article
4. Tsai MS, You HL, Tang YF, Liu JW. Shewanella soft tissue infection: case report and literature review. Int J Infect Dis. 2008. 12:e119–e124.
5. Myung DS, Jung YS, Kang SJ, Song YA, Park KH, Jung SI, Kim SH, Shin JH. Primary Shewanella algae bacteremia mimicking Vibrio septicemia. J Korean Med Sci. 2009. 24:1192–1194.
Article
6. Schmidt U, Kapila R, Kaminski Z, Louria D. Pseudomonas putrefaciens as a cause of septicemia in humans. J Clin Microbiol. 1979. 10:385–387.
Article
7. Yohe S, Fishbain JT, Andrews M. Shewanella putrefaciens abscess of the lower extremity. J Clin Microbiol. 1997. 35:3363.
Article
8. Vandepitte J, Debois J. Pseudomonas putrefaciens as a cause of bacteremia in humans. J Clin Microbiol. 1978. 7:70–72.
Article
9. Tsai TH, You HY. Necrotizing fasciitis caused by Shewanella putrefaciens in a uremic patient. J Microbiol Immunol Infect. 2006. 39:516–518.
10. Saidel-Odes L, Borer A, Riesenberg K, Schlaeffer F. Shewanella spp. infection following treatment for upper gastrointestinal bleeding. Scand J Infect Dis. 2007. 39:360–361.
Article
11. Pagani L, Lang A, Vedovelli C, Moling O, Rimenti G, Pristera R, Mian P. Soft tissue infection and bacteremia caused by Shewanella putrefaciens. J Clin Microbiol. 2003. 41:2240–2241.
Article
12. Kim DM, Kang CI, Lee CS, Kim HB, Kim EC, Kim NJ, Oh MD, Choe KW. Treatment failure due to emergence of resistance to carbapenem during therapy for Shewanella algae bacteremia. J Clin Microbiol. 2006. 44:1172–1174.
Article
13. Iwata M, Tateda K, Matsumoto T, Furuya N, Mizuiri S, Yamaguchi K. Primary Shewanella alga septicemia in a patient on hemodialysis. J Clin Microbiol. 1999. 37:2104–2105.
Article
14. Domínguez H, Vogel BF, Gram L, Hoffmann S, Schaebel S. Shewanella algae bacteremia in two patients with lower leg ulcers. Clin Infect Dis. 1996. 22:1036–1039.
15. Debois J, Degreef H, Vandepitte J, Spaepen J. Pseudomonas putrefaciens as a cause of infection in humans. J Clin Pathol. 1975. 28:993–996.
16. Winn WC, Allen SD, Janda WM, Koneman EW, Procop GW, Schreckenberger PC, Woods GL. Koneman's color atlas and textbook of diagnostic microbiology. 2006. 6th ed. Philadelphia: Lippincott Williams & Wilkins;336–337.
17. Chen YS, Liu YC, Yen MY, Wang JH, Wann SR, Cheng DL. Skin and soft-tissue manifestations of Shewanella putrefaciens infection. Clin Infect Dis. 1997. 25:225–229.
Article
18. Simidu U, Kita-Tsukamoto K, Yasumoto T, Yotsu M. Taxonomy of four marine bacterial strains that produce tetrodotoxin. Int J Syst Bacteriol. 1990. 40:331–336.
Article
19. Khashe S, Janda JM. Biochemical and pathogenic properties of Shewanella algae and Shewanella putrefaciens. J Clin Microbiol. 1998. 36:783–787.
Article
20. Brink AJ, van Straten A, van Rensburg AJ. Shewanella (Pseudomonas) putrefaciens bacteremia. Clin Infect Dis. 1995. 20:1327–1332.
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