Aeromonas sobria infection with severe soft tissue damage and segmental necrotizing gastroenteritis in a patient with alcoholic liver cirrhosis

A 49-year-old man, who had a 3-year history of liver dysfunction but had no t been treated, was admitted to the hospital with a sudden onset of fever a nd generalized muscle pain. He subsequently developed generalized purpura w ith scattered hemorrhagic bullae of the skin and massive bloody stools. Aer omonas sobria was proven by culture of both blood and bullous fluid. In spi te of the extensive treatment with antibiotics and other medications in the intensive care unit (ICU), the patient went into septic shock and died 2 d ays after admission. Pathological examination on autopsy revealed segmental necrotizing gastroenteritis with bacterial colonies and alcoholic liver ci rrhosis, in addition to extensive severe soft tissue damage involving cellu litis and rhabdomyolysis and epidermolysis, Although the prognosis for Vibr io vulnificus infection with severe soft tissue damage in patients with liv er cirrhosis, malignancy, diabetes mellitus or other pre-existing diseases is poor, the unfavorable progression of Aeromonas species, especially A. so bria infection is rare. This is thought to be the first report of an autops ied case.