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Surgical site infection caused by Aeromonas hydrophila presenting as necrotizing soft tissue infection after esophagectomy
Author(s) -
Yamasaki Osamu,
Takahashi Eizo,
Noda Kazuyo,
Kanaya Nobuhiko,
Tanabe Shunsuke,
Shirakawa Yasuhiro,
Morizane Shin
Publication year - 2020
Publication title -
the journal of dermatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.9
H-Index - 65
eISSN - 1346-8138
pISSN - 0385-2407
DOI - 10.1111/1346-8138.15323
Subject(s) - aeromonas hydrophila , medicine , esophagectomy , soft tissue , septic shock , virulence , debridement (dental) , necrosis , lymph node , surgery , sepsis , microbiology and biotechnology , pathology , cancer , esophageal cancer , biology , biochemistry , genetics , bacteria , gene
Several virulence factors of Aeromonas such as hemolysin, proteases and lipases have been characterized. The relationship between these virulence factors and disease remains unclear. A 71‐year‐old man underwent thoracoscopic esophagectomy, lymph node dissection and Roux‐en‐Y reconstruction for esophageal cancer. On postoperative day 1, redness around the wound on the thoracic abdominal wall gradually enlarged and necrosis became apparent with septic shock. Necrotizing soft tissue infection was suspected and emergency surgical debridement was performed. Blood and wound cultures were positive for Aeromonas hydrophila . The strain was found to have hemolytic activity, proteolytic activity and extremely high elastolytic activity. In addition, the strain actively produced elastolytic metalloprotease, which may contribute to extensive tissue necrosis.