Fracking, worksite injuries, and Aeromonas infection

Hydraulic fracturing or fracking is a method of extracting natural gas from the earthusing high pressure drilling equipment and fracking fluid that contains proppant and variouschemicals. It poses health risks to workers at the drilling sites, has effects on water and airquality, and creates potential health risks for people living near the drilling sites. A 30-yearoldman with no past medical history presented as transfer from an outside hospital after anexplosion on a fracking job site. This explosion released over 6000 pounds of water that threwhim 20 feet across the rig. He had radial and ulnar fractures in his right arm and digital fractureson his right hand. He also had trauma to his left knee and right posterior thigh with a largefluctuant Morel-Lavallee lesion. On day 3 the patient developed hypotension, lethargy, andnew onset fever from a possible infection of a hematoma; he was started on norepinephrineand intubated due to a decreased mental status. Cultures from the thigh were positive forAeromonas species. Aeromonas is a Gram-negative rod that is found in many environmentsthat contain water. Studies have shown that this organism grows commonly in West Texas andNew Mexico in river beds and lakes. Healthcare providers should keep Aeromonas spp in theirdifferential list of pathogens in patients with abrasions and open injuries that occurred aroundor in a body of water.