Septic shock due to Aeromonas hydrophila bacteremia in a patient with alcoholic liver cirrhosis: a case report

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• 作者：Tetsuya Yumoto (2)
  Shingo Ichiba (2)
  Nao Umei (2)
  Sunao Morisada (2)
  Kohei Tsukahara (2)
  Keiji Sato (2)
  Toyomu Ugawa (2)
  Yoshihito Ujike (2)
  
  2. Advanced Emergency and Critical Care Medical Center ; Okayama University Hospital ; 2-5-1 Kita-ku ; Shikata-cho ; Okayama-shi ; Okayama ; 700-8558 ; Japan
  
• 关键词：Aeromonas hydrophila ; Liver cirrhosis ; Septic shock
• 刊名：Journal of Medical Case Reports
• 出版年：2014
• 出版时间：December 2014
• 年：2014
• 卷：8
• 期：1
• 全文大小：372 KB
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• 刊物主题：Medicine/Public Health, general; General Practice / Family Medicine; Public Health; Primary Care Medicine;
• 出版者：BioMed Central
• ISSN：1752-1947

文摘

Introduction Aeromonas hydrophila sometimes causes bacteremia, which can be fatal in compromised patients, such as those with liver cirrhosis. We present a case of septic shock due to Aeromonas hydrophila bacteremia in a patient with liver cirrhosis, which was successfully treated with rapid resuscitation and critical care. Case presentation A 71-year-old Japanese man with liver cirrhosis was transported to our emergency center by ambulance after presenting with gait difficulties and fever. On arrival, he exhibited shock and severe lactic acidosis, which was suggestive of sepsis, and was immediately resuscitated and administered empiric antibiotic therapy. He also displayed catecholamine-resistant hypotension, which was successfully treated with critical care including supportive therapies, such as polymyxin B hemoperfusion and cytokine-absorbing hemofiltration. Aeromonas hydrophila was detected in his initial blood cultures. Conclusions Aeromonas septicemia should be considered in patients with alcoholic liver cirrhosis who have profound shock. In addition to goal-directed therapy and the prompt administration of empiric antibiotic therapy, aggressive critical care involving multiple supportive therapies can save such patients.