Spontaneous bacterial peritonitis caused by Edwardsiella tarda: A case report. (2020)

• Record Type: Journal Article
• Authors: Hayashi, Hirokatsu; Murase, Yusuke; Sano, Hitoya; Nishio, Kimitosi; Kumazawa, Iwao
• Is Part Of: International journal of surgery case reports. Volume 75(2020)
• Page Start: 422
• Page End: 425
• Publication Date: 2020
• Subjects: SBP spontaneous bacterial peritonitis -- CT computed tomography -- MOF multiple organ failure; Edwardsiella tarda -- Spontaneous bacterial peritonitis -- Cirrhosis; Surgery -- Periodicals; Surgical Procedures, Operative -- Periodicals; Surgery; Electronic journals; Periodicals; 617.005
• DOI: 10.1016/j.ijscr.2020.09.126
• Languages: English
• ISSNs: 2210-2612

Abstract

Highlights: Case of spontaneous bacterial peritonitis associated with E. tarda infection. The patient had Child–Pugh A cirrhosis secondary to hepatitis C virus infection. Surgical findings included redness and thickening of the cecal wall. Purulent ascites without intestinal contents was observed. E. tarda infection has a poor prognosis in patients with underlying disease. Abstract: Introduction: Edwardsiella tarda is a member of the Enterobacteriaceae family of gram-negative bacilli isolated from animals. Gastroenteritis is the most common manifestation of E. tarda infection. However, extraintestinal infections can occur in immunocompromised hosts as well as patients with hepatobiliary disease, malignancy, and/or diabetes mellites. The prognosis of sepsis caused by E. tarda is extremely poor, with a mortality rate of 38%. Here we report the occurrence of spontaneous bacterial peritonitis associated with E. tarda infection. Presentation of case: An 87-year-old man with Child–Pugh A cirrhosis secondary to hepatitis C virus infection presented with diarrhea and sudden-onset pain in the abdomen. On arrival, guarding and rebound tenderness were observed over the entire abdomen. Computed tomography revealed circumferential thickening of the cecum and a small volume of ascites in the pelvic cavity. A diagnosis of peritonitis was made, and surgery was performed. Surgical findings included redness and thickening of the cecal wall and purulent ascites without intestinal contents. Peritoneal fluid culture revealed E. tarda as the sole pathogen. The abdominal cavity was washed, a drain was placed in the pelvic cavity, and postoperative intravenous antibiotic therapy was initiated. The postoperative course was uneventful. Discussion: E. tarda infection in the presence of an underlying disease such as hepatobiliary disease, malignancy, and/or diabetes mellitus has a poor prognosis. Conclusion: Although E. tarda infection is extremely rare, it is a life-threatening illness that can cause intestinal and extraintestinal infections. If necessary, early surgical intervention should be considered for cases of extraintestinal infection.