Spontaneous bacterial peritonitis caused by Aeromonas caviae in a patient with cirrhosis.
10.11817/j.issn.1672-7347.2015.03.017
- Author:
Deyu HUANG
1
;
Ying ZHAO
;
Yueping JIANG
;
Zhongbin LI
;
Wucai YANG
;
Guofeng CHEN
Author Information
1. Department of Infectious Disease, Affi liated Hospital of Qingdao University, Qingdao Shandong 266003, China.
- Publication Type:Journal Article
- MeSH:
Aeromonas caviae;
Anti-Infective Agents;
Ascitic Fluid;
Gram-Negative Bacterial Infections;
pathology;
Humans;
Leukocyte Count;
Liver Cirrhosis;
Male;
Microbial Sensitivity Tests;
Peritonitis;
microbiology;
pathology
- From:
Journal of Central South University(Medical Sciences)
2015;40(3):341-344
- CountryChina
- Language:English
-
Abstract:
Spontaneous bacterial peritonitis (SBP) is a common complication of cirrhosis. Based on our current understanding of SBP, the most common etiologies for SBP in cirrhosis are Enterobacter and Streptococcal species. Th e Aeromonas species are ubiquitous in fresh or sea water. Aeromonas caviae is never identified as etiology in cases of SBP. A patient, who had a history of liver cirrhosis related to chronic hepatitis B virus infection for 1 year, presented with diarrhea. He had diarrhea 1 week later returned from coastal city. He was hospitalized and treated with norfloxacin after 7 days of severe symptoms, including fever, abdominal distention, and diarrhea. Analysis of the ascitic specimen revealed a white-cell count of 4.42 × 109 cells/L with 88% neutrophils. Analysis of stool specimen showed a white-cell count of 60 cells per high-power field. Th e patient started the injection of cefriaxone at a dose of 4 g/d. However, the situation was not improved. Th ree days later, stool and ascitic fluid culture showed positive for Aeromonas caviae. Antibiotic susceptibility testing revealed that imipenem, meropenem, amikacin, and cefoperazone-sulbactam were highly sensitive to the Aeromonas caviae. However, the bacilli resisted to ceftriaxone, ceftazidime, ampicillin-sulbactam, levofloxacin, and sulfamethoxazole. Ceftriaxone was then switched to imipenem. The patient was fully recovered 14 days later. Aeromonas caviae is a rare pathogen of SBP in cirrhosis. It resists to third-generation of cephalosporin and fluroquinolone, which are of frequently used dependent on clinical experience. It needs a special attention.
